Provider Demographics
NPI:1225063050
Name:MUELLER, JAMES M (LICSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:MUELLER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 DWIGHT RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1752
Mailing Address - Country:US
Mailing Address - Phone:413-567-1955
Mailing Address - Fax:413-567-1956
Practice Address - Street 1:167 DWIGHT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1752
Practice Address - Country:US
Practice Address - Phone:413-567-1955
Practice Address - Fax:413-567-1956
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1069251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000031119OtherBMC HEALTHNET PLAN
MA024072OtherVALUEOPTIONS
MA62-66753OtherUNITED BEHAVIORAL HEALTH
MAP04983OtherBLUE CROSS/BLUE SHIELD
MAP2267038OtherOXFORD HEALTH PLANS
MA62-66753OtherUNITED BEHAVIORAL HEALTH
MAP04983Medicare ID - Type Unspecified