Provider Demographics
NPI:1477610376
Name:GELINAS, DENISE JEANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:JEANNE
Last Name:GELINAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2165
Mailing Address - Country:US
Mailing Address - Phone:413-586-4225
Mailing Address - Fax:413-584-4923
Practice Address - Street 1:277 MAIN ST
Practice Address - Street 2:RM 203
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3171
Practice Address - Country:US
Practice Address - Phone:413-584-2617
Practice Address - Fax:413-584-4923
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW 02501OtherBLUE CROSSBLUE SHIELD NU
MAW 02-501Medicare ID - Type UnspecifiedMEDICARE NUMBER