Provider Demographics
NPI:1669280087
Name:SOMETHING DIFFERENT CLINICAL SERVICES PLLC
Entity type:Organization
Organization Name:SOMETHING DIFFERENT CLINICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-271-7309
Mailing Address - Street 1:94 N ELM ST STE 301A
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1641
Mailing Address - Country:US
Mailing Address - Phone:413-271-7309
Mailing Address - Fax:
Practice Address - Street 1:94 N ELM ST STE 301A
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1641
Practice Address - Country:US
Practice Address - Phone:413-271-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty