Provider Demographics
NPI:1023165131
Name:NIELDS-DUFFY, TOM (MA)
Entity type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:NIELDS-DUFFY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TRUMBULL RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3036
Mailing Address - Country:US
Mailing Address - Phone:413-237-0134
Mailing Address - Fax:
Practice Address - Street 1:31 TRUMBULL RD UNIT B
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3036
Practice Address - Country:US
Practice Address - Phone:413-237-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7668101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health