Provider Demographics
NPI:1417029323
Name:MACHAK, CATHY L (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:L
Last Name:MACHAK
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BROCKWAY LANE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075
Mailing Address - Country:US
Mailing Address - Phone:413-532-8253
Mailing Address - Fax:
Practice Address - Street 1:33 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105
Practice Address - Country:US
Practice Address - Phone:413-846-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2102141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical