Provider Demographics
NPI:1669657953
Name:BERKOWITZ-GOSSELIN, LEAH (LCSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BERKOWITZ-GOSSELIN
Suffix:
Gender:F
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:PO BOX 1402
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-1402
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:24 N MAPLE ST STE 5
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1323
Practice Address - Country:US
Practice Address - Phone:413-206-7692
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1159131041C0700X
MA2150001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical