Provider Demographics
NPI:1477085348
Name:KARUNA PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:KARUNA PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-623-1777
Mailing Address - Street 1:200 N MAIN ST
Mailing Address - Street 2:SOUTH BUILDING SUITE 3
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2354
Mailing Address - Country:US
Mailing Address - Phone:860-623-1777
Mailing Address - Fax:
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:UNIT 3 SUITE 9
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028
Practice Address - Country:US
Practice Address - Phone:860-607-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10062103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty