Provider Demographics
NPI:1982944237
Name:PERSSON, NANCY E
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:PERSSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 SOUTH ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8242
Mailing Address - Country:US
Mailing Address - Phone:413-236-5656
Mailing Address - Fax:
Practice Address - Street 1:877 SOUTH ST
Practice Address - Street 2:STE. 200
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8242
Practice Address - Country:US
Practice Address - Phone:413-236-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2179891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical