Provider Demographics
NPI:1295279909
Name:HEALEY, DANIEL K (MED CCC-A)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:K
Last Name:HEALEY
Suffix:
Gender:M
Credentials:MED CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CAREW ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2301
Mailing Address - Country:US
Mailing Address - Phone:413-734-4918
Mailing Address - Fax:413-734-4919
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:SUITE 330
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2301
Practice Address - Country:US
Practice Address - Phone:413-734-4918
Practice Address - Fax:413-734-4919
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAD0087OtherBLUE CROSS
MAHE025764Medicare PIN