Provider Demographics
NPI:1487845137
Name:BAEZ, ANGELA B (LMHC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:BAEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01128-1105
Mailing Address - Country:US
Mailing Address - Phone:413-782-2578
Mailing Address - Fax:
Practice Address - Street 1:235 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5123
Practice Address - Country:US
Practice Address - Phone:413-532-0389
Practice Address - Fax:413-532-1548
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health