| Colorful Resilience Llc | |
|
201 Park Ave Ste 9 West Springfield MA 01089-3366 | |
| (413) 213-2979 | |
| Not Available |
| Full Name | Colorful Resilience Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Park Ave Ste 9, West Springfield, Massachusetts |
| Authorized Official Name and Position | Mayrena Guerrero (FOUNDER & CEO) |
| Authorized Official Contact | 4132132979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorful Resilience Llc 201 Park Ave Ste 9 West Springfield MA 01089-3366 Ph: (413) 213-2979 | Colorful Resilience Llc 201 Park Ave Ste 9 West Springfield MA 01089-3366 Ph: (413) 213-2979 |
| NPI Number | 1669122289 |
|---|---|
| Provider Enumeration Date | 03/26/2022 |
| Last Update Date | 03/26/2022 |
| Certification Date | 03/26/2022 |
| Medicare PECOS PAC ID | 1355793639 |
|---|---|
| Medicare Enrollment ID | O20240123001610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669122289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Stephanie Presson-lapre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366703746 PECOS PAC ID: 0547534570 Enrollment ID: I20170914002140 |
| Provider Name | Janet Namono |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588017024 PECOS PAC ID: 2860741584 Enrollment ID: I20180814001127 |
| Provider Name | Rachel Flichtbeil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831447069 PECOS PAC ID: 3870834369 Enrollment ID: I20190410001794 |
| Provider Name | Elizabeth M A Shurman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992943963 PECOS PAC ID: 0042642654 Enrollment ID: I20191120002489 |
| Provider Name | Holly Okula Mcmahon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902274673 PECOS PAC ID: 8729430020 Enrollment ID: I20240123002226 |
| Provider Name | Naarah Macklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770930901 PECOS PAC ID: 1355793555 Enrollment ID: I20240123002318 |
| Provider Name | Nicole Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013067032 PECOS PAC ID: 3870945074 Enrollment ID: I20240123002416 |
| Provider Name | Susana Puertas Manso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174945307 PECOS PAC ID: 7911350087 Enrollment ID: I20240125002332 |
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