Provider Demographics
NPI:1538674494
Name:NORTHAMPTON CENTER FOR COUPLES THERAPY, LLC
Entity Type:Organization
Organization Name:NORTHAMPTON CENTER FOR COUPLES THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LUSIGNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:413-626-4707
Mailing Address - Street 1:40 MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3100
Mailing Address - Country:US
Mailing Address - Phone:413-586-2300
Mailing Address - Fax:
Practice Address - Street 1:40 MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3100
Practice Address - Country:US
Practice Address - Phone:413-586-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty