Provider Demographics
NPI:1558543835
Name:WOOD, HERBERT B (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:B
Last Name:WOOD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 AMES RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9110
Mailing Address - Country:US
Mailing Address - Phone:413-566-3518
Mailing Address - Fax:413-566-2123
Practice Address - Street 1:254 AMES RD
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9110
Practice Address - Country:US
Practice Address - Phone:413-566-3518
Practice Address - Fax:413-566-2123
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2141991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical