| Golden Years Behavioral Health Group Inc. | |
|
16 Shaker Road East Longmeadow MA 01028 | |
| (413) 209-8208 | |
| (413) 287-9737 |
| Full Name | Golden Years Behavioral Health Group Inc. |
|---|---|
| Speciality | Counselor |
| Location | 16 Shaker Road, East Longmeadow, Massachusetts |
| Authorized Official Name and Position | Tracy L Mineo (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 4132242015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Years Behavioral Health Group Inc. 18 Shaker Road East Longmeadow MA 01028 Ph: (413) 224-2015 | Golden Years Behavioral Health Group Inc. 16 Shaker Road East Longmeadow MA 01028 Ph: (413) 209-8208 |
| NPI Number | 1174142509 |
|---|---|
| Provider Enumeration Date | 04/15/2020 |
| Last Update Date | 06/09/2022 |
| Certification Date | 06/01/2022 |
| Medicare PECOS PAC ID | 8921417452 |
|---|---|
| Medicare Enrollment ID | O20210512002666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174142509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Amy J Weiswasser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093115172 PECOS PAC ID: 6608122486 Enrollment ID: I20180710000338 |
| Provider Name | E. Brigid Mcbride |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528318789 PECOS PAC ID: 0648510370 Enrollment ID: I20190315002476 |
| Provider Name | Sara Kendall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356432751 PECOS PAC ID: 8022358415 Enrollment ID: I20190410001212 |
| Provider Name | Deborah Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396989547 PECOS PAC ID: 8123437662 Enrollment ID: I20210512003002 |
| Provider Name | Kristy Navarro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922488782 PECOS PAC ID: 2466847892 Enrollment ID: I20220321002158 |
| Provider Name | Jessica Ann Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851854285 PECOS PAC ID: 6608215520 Enrollment ID: I20240411002665 |
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