Provider Demographics
NPI:1659437804
Name:SENZEL, SHANA (PSYD)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:SENZEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:MEMORY DISORDER PROGRAM
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2877
Mailing Address - Fax:413-496-6837
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:MEMORY DISORDER PROGRAM
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2877
Practice Address - Fax:413-496-6837
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8489103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist