Miriah D Beaudoin

Individual provider Active NPI Clinical Social Worker · Chicopee, MA

NPI 1427366392 · NPPES record last updated Sep 14, 2010

Key facts

NPI
1427366392
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
111 Casino Ave
Chicopee, MA 01013-2561
Phone
(413) 265-1209
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

111 Casino Ave
Chicopee, MA 01013-2561

Mailing address

111 Casino Avenue
Chicopee, MA 01013

Other providers in Chicopee, MA

All providers in Chicopee, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.