Provider Demographics
NPI:1912273640
Name:TALBOT, HENRY RAU (MSW, LCSW, LADC1)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:RAU
Last Name:TALBOT
Suffix:
Gender:M
Credentials:MSW, LCSW, LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-0364
Mailing Address - Country:US
Mailing Address - Phone:413-224-1606
Mailing Address - Fax:413-224-1606
Practice Address - Street 1:38 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2201
Practice Address - Country:US
Practice Address - Phone:413-374-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1184101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)