| Mental Health Association, Inc. | |
|
1 Federal St Bldg 103-1 Springfield MA 01105-1199 | |
| (413) 734-5376 | |
| (413) 737-7949 |
| Full Name | Mental Health Association, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1 Federal St Bldg 103-1, Springfield, Massachusetts |
| Authorized Official Name and Position | Sarah Smith (VP OF FINANCE) |
| Authorized Official Contact | 4132335376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Association, Inc. 350 Memorial Dr Chicopee MA 01020-5000 Ph: (413) 734-5376 | Mental Health Association, Inc. 1 Federal St Bldg 103-1 Springfield MA 01105-1199 Ph: (413) 734-5376 |
| NPI Number | 1285104141 |
|---|---|
| Provider Enumeration Date | 12/04/2018 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Medicare PECOS PAC ID | 6305186784 |
|---|---|
| Medicare Enrollment ID | O20190321001439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285104141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Maxim Lianski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417997818 PECOS PAC ID: 3375507841 Enrollment ID: I20041115000740 |
| Provider Name | Vikram Kambampati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336352624 PECOS PAC ID: 9335227586 Enrollment ID: I20141110000033 |
| Provider Name | Austin Enomah Agbonifo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750927489 PECOS PAC ID: 3072929314 Enrollment ID: I20210310002203 |
| Provider Name | Jose N Garcia-mercado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346594512 PECOS PAC ID: 6103232491 Enrollment ID: I20210311000967 |
| Provider Name | Katrin Weir |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154451177 PECOS PAC ID: 3476969106 Enrollment ID: I20210330000591 |
| Provider Name | Raven Adair Omuemu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720741812 PECOS PAC ID: 4082005764 Enrollment ID: I20220107000850 |
| Provider Name | Sequilla Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518476647 PECOS PAC ID: 2769819697 Enrollment ID: I20221031001553 |
| Provider Name | Amy M Conklin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538627633 PECOS PAC ID: 3274902671 Enrollment ID: I20221207000145 |
| Provider Name | Rosibel Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801363197 PECOS PAC ID: 6204288020 Enrollment ID: I20240117003251 |
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