Provider Demographics
NPI:1609921873
Name:COUNSELING CENTER IN THE BERKSHIRES INC
Entity Type:Organization
Organization Name:COUNSELING CENTER IN THE BERKSHIRES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:413-499-4090
Mailing Address - Street 1:34 DEPOT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5130
Mailing Address - Country:US
Mailing Address - Phone:413-499-4090
Mailing Address - Fax:413-499-1844
Practice Address - Street 1:34 DEPOT ST STE 201
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5130
Practice Address - Country:US
Practice Address - Phone:413-499-4090
Practice Address - Fax:413-499-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183317101YM0800X
MA6646103TB0200X
MA2157103TB0200X
MA4448103TB0200X
MA4011103TB0200X
MA8079103TC0700X
MA8089103TC0700X
MA10162181041C0700X
MA1065851041C0700X
MA10276041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12768300OtherMAGELLAN
MA667870OtherTUFTS HEALTH PLAN
MAW40032Medicare PIN