Provider Demographics
NPI:1770640831
Name:STRAUSS, ERIC S (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 ELM ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1540
Mailing Address - Country:US
Mailing Address - Phone:413-736-8158
Mailing Address - Fax:413-736-8212
Practice Address - Street 1:1111 ELM ST
Practice Address - Street 2:SUITE 6
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-736-8158
Practice Address - Fax:413-736-8212
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1702103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW01731OtherBLUE SHIELD PROVIDER NUMB
W01731Medicare ID - Type Unspecified