| African Diaspora Mental Health Association Llc. | |
|
605 State St Springfield MA 01109-4114 | |
| (413) 262-7414 | |
| Not Available |
| Full Name | African Diaspora Mental Health Association Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 State St, Springfield, Massachusetts |
| Authorized Official Name and Position | David Allan Lewis (ADMINISTRATOR/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4132627414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| African Diaspora Mental Health Association Llc. 605 State St Springfield MA 01109-4114 Ph: (413) 266-2207 | African Diaspora Mental Health Association Llc. 605 State St Springfield MA 01109-4114 Ph: (413) 262-7414 |
| NPI Number | 1558884338 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 07/26/2021 |
| Certification Date | 07/26/2021 |
| Medicare PECOS PAC ID | 2668737222 |
|---|---|
| Medicare Enrollment ID | O20180531002024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558884338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joseph Cheng Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972638286 PECOS PAC ID: 9133381635 Enrollment ID: I20120430000287 |
| Provider Name | Gabriel Arimoro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023209442 PECOS PAC ID: 9032208418 Enrollment ID: I20180321002206 |
| Provider Name | David Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285969220 PECOS PAC ID: 4880949080 Enrollment ID: I20180612000544 |
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