Provider Demographics
NPI:1841407145
Name:PANANAS, ANGELO (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANGELO
Middle Name:
Last Name:PANANAS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9724
Mailing Address - Country:US
Mailing Address - Phone:413-896-8436
Mailing Address - Fax:
Practice Address - Street 1:10 CENTRAL ST
Practice Address - Street 2:SUITE 27
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-2700
Practice Address - Country:US
Practice Address - Phone:413-732-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health