| Cooley Dickinson Medical Group | |
|
22 Atwood Dr Suite 205 Northampton MA 01060-4272 | |
| (413) 582-2175 | |
| (413) 923-9322 |
| Full Name | Cooley Dickinson Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 22 Atwood Dr, Northampton, Massachusetts |
| Authorized Official Name and Position | Norman Stachelek (PRESIDENT/CEO) |
| Authorized Official Contact | 4135822653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooley Dickinson Medical Group 30 Locust St Cooley Dickinson Medical Group Northampton MA 01060-2052 Ph: (413) 582-2898 | Cooley Dickinson Medical Group 22 Atwood Dr Suite 205 Northampton MA 01060-4272 Ph: (413) 582-2175 |
| NPI Number | 1942605373 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 10/28/2014 |
| Medicare PECOS PAC ID | 2567359839 |
|---|---|
| Medicare Enrollment ID | O20150114001513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942605373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Massachusetts) | Primary |
| Provider Name | Marlene G Meinelt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366693426 PECOS PAC ID: 6800786377 Enrollment ID: I20040405000645 |
| Provider Name | Peter Halperin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992736482 PECOS PAC ID: 2668505694 Enrollment ID: I20101025001028 |
| Provider Name | Kelly M Buckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669941738 PECOS PAC ID: 9234545526 Enrollment ID: I20210311001361 |
| Provider Name | Chelsea Cotton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518605401 PECOS PAC ID: 2163884768 Enrollment ID: I20230814003821 |
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