| Mental Health Therapeutic Innovation | |
|
191 Chestnut St Ste 2c Springfield MA 01103-1512 | |
| (413) 210-8800 | |
| Not Available |
| Full Name | Mental Health Therapeutic Innovation |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 191 Chestnut St Ste 2c, Springfield, Massachusetts |
| Authorized Official Name and Position | Luis Francisco Gonzalez Colon (OWNDER) |
| Authorized Official Contact | 4132108800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Therapeutic Innovation Po Box 4149 Springfield MA 01101-4149 Ph: (413) 210-8800 | Mental Health Therapeutic Innovation 191 Chestnut St Ste 2c Springfield MA 01103-1512 Ph: (413) 210-8800 |
| NPI Number | 1437754579 |
|---|---|
| Provider Enumeration Date | 12/04/2020 |
| Last Update Date | 06/30/2021 |
| Certification Date | 06/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437754579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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