Provider Demographics
NPI:1699224568
Name:PIONEER VALLEY COUNSELING
Entity Type:Organization
Organization Name:PIONEER VALLEY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:T
Authorized Official - Last Name:KELLEHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:413-222-9375
Mailing Address - Street 1:10 CENTER ST STE 408
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-2784
Mailing Address - Country:US
Mailing Address - Phone:413-222-9375
Mailing Address - Fax:413-331-5395
Practice Address - Street 1:10 CENTER ST STE 408
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-2784
Practice Address - Country:US
Practice Address - Phone:413-222-9375
Practice Address - Fax:413-331-5395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty