Provider Demographics
NPI:1932247475
Name:CLEAVELAND, ANN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:CLEAVELAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:CLEAVELAND
Other - Last Name:GAUBINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:100 KING ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3243
Mailing Address - Country:US
Mailing Address - Phone:413-586-6847
Mailing Address - Fax:413-584-8416
Practice Address - Street 1:100 KING ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3243
Practice Address - Country:US
Practice Address - Phone:413-586-6847
Practice Address - Fax:413-584-8416
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1034741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP20889Medicare PIN