Individual and Family Counseling Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

106947 Issued in MA

Legal business name

INDIVIDUAL AND FAMILY COUNSELING CENTER, LLC

Practice address

200 Silver Street
106
Agawam, MA 01001-1647

Phone

(413) 789-9198

Fax

(413) 789-6322

NPI assigned

Jul 22, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Cristina Di Nardo-Dupre, LICSW

Title

Social Worker/Owner

Phone

(413) 789-9198

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234742400000",
    "number": "1699930370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SILVER STREET",
            "address_2": "106",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011647",
            "telephone_number": "413-789-9198",
            "fax_number": "413-789-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SILVER STREET",
            "address_2": "106",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011647",
            "telephone_number": "413-789-9198",
            "fax_number": "413-789-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL AND FAMILY COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2009-02-16",
        "status": "A",
        "authorized_official_last_name": "DI NARDO-DUPRE",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "413-789-9198",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "106947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "P04545",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "11831",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "791017",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Agawam, MA
• Providers in Agawam, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.