Provider Demographics
NPI:1588676878
Name:TURCHINETZ, TILDY R (LICSW)
Entity Type:Individual
Prefix:
First Name:TILDY
Middle Name:R
Last Name:TURCHINETZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 ASHFIELD ST
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-1423
Mailing Address - Country:US
Mailing Address - Phone:413-625-9520
Mailing Address - Fax:
Practice Address - Street 1:238 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3243
Practice Address - Country:US
Practice Address - Phone:413-774-6252
Practice Address - Fax:413-773-0477
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10178801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22618Medicare ID - Type UnspecifiedPANEL