Provider Demographics
NPI:1811136518
Name:NORTHFIELD MOUNT HERMON O'CONNOR HEALTH CENTER PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:NORTHFIELD MOUNT HERMON O'CONNOR HEALTH CENTER PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:413-498-3570
Mailing Address - Street 1:1 LAMPLIGHTER WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT HERMON
Mailing Address - State:MA
Mailing Address - Zip Code:01354-9638
Mailing Address - Country:US
Mailing Address - Phone:413-498-3407
Mailing Address - Fax:413-498-3147
Practice Address - Street 1:1 LAMPLIGHTER WAY
Practice Address - Street 2:
Practice Address - City:MOUNT HERMON
Practice Address - State:MA
Practice Address - Zip Code:01354-9637
Practice Address - Country:US
Practice Address - Phone:413-498-3407
Practice Address - Fax:413-498-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4655261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health