Provider Demographics
NPI:1760528723
Name:VANASSE, JAMES A (MSW,LICSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:VANASSE
Suffix:
Gender:M
Credentials:MSW,LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:PARTIAL HOSPITAL PROGRAM
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2747
Mailing Address - Fax:413-447-2041
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:PARTIAL HOSPITAL PROGRAM
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2747
Practice Address - Fax:413-447-2041
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1067391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical