| Ivelisse Vicente Licsw | |
|
62 Leona Ave Chicopee MA 01013-3319 | |
| (413) 377-0677 | |
| Not Available |
| Full Name | Ivelisse Vicente Licsw |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 62 Leona Ave, Chicopee, Massachusetts |
| Authorized Official Name and Position | Ivelisse Vicente (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4133770677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivelisse Vicente Licsw Po Box 1086 Chicopee MA 01021-1086 Ph: (413) 377-0677 | Ivelisse Vicente Licsw 62 Leona Ave Chicopee MA 01013-3319 Ph: (413) 377-0677 |
| NPI Number | 1982432324 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 07/25/2024 |
| Certification Date | 07/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982432324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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