Provider Demographics
NPI:1740041078
Name:MONZON, JOSE MANUEL SR
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:MONZON
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST BLDG 102-3
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-2390
Mailing Address - Country:US
Mailing Address - Phone:413-737-9544
Mailing Address - Fax:413-737-9544
Practice Address - Street 1:1 FEDERAL ST BLDG 102-3
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-2390
Practice Address - Country:US
Practice Address - Phone:413-737-9544
Practice Address - Fax:413-737-9544
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical