| Gandara Mental Health Center | |
|
120 Maple St Springfield MA 01103-2203 | |
| (413) 846-0445 | |
| Not Available |
| Full Name | Gandara Mental Health Center |
|---|---|
| Speciality | Counselor |
| Location | 120 Maple St, Springfield, Massachusetts |
| Authorized Official Name and Position | Leonel Lasanta (CLINICIAN) |
| Authorized Official Contact | 4138460445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gandara Mental Health Center 120 Maple St Springfield MA 01103-2203 Ph: (413) 846-0445 | Gandara Mental Health Center 120 Maple St Springfield MA 01103-2203 Ph: (413) 846-0445 |
| NPI Number | 1740723436 |
|---|---|
| Provider Enumeration Date | 11/29/2016 |
| Last Update Date | 11/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740723436 | NPI | - | NPPES |
| 1134107113 | Other | MA | NHP |
| 1134107113 | Other | MA | MBHP |
| 1134107113 | Other | MA | BEACON |
| 71756 | Other | MA | TUFTS |
| 12529 | Other | MA | HNE |
| 997303 | Other | MA | NETWORK HEALTH |
| 1134107113 | Other | MA | FALLON |
| 1307576 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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