| Stepping Stones Psychiatry, Llc | |
|
201 Park Ave Ste 5 West Springfield MA 01089-3366 | |
| (413) 300-3999 | |
| (413) 315-5743 |
| Full Name | Stepping Stones Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 201 Park Ave Ste 5, West Springfield, Massachusetts |
| Authorized Official Name and Position | Elizabeth F Gormally (BILLER) |
| Authorized Official Contact | 4135315624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stepping Stones Psychiatry, Llc Po Box 1080 Belchertown MA 01007-1080 Ph: (413) 531-5624 | Stepping Stones Psychiatry, Llc 201 Park Ave Ste 5 West Springfield MA 01089-3366 Ph: (413) 300-3999 |
| NPI Number | 1679155923 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Medicare PECOS PAC ID | 6709289531 |
|---|---|
| Medicare Enrollment ID | O20210730000961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679155923 | NPI | - | NPPES |
| 110033706A | Medicaid | MA | |
| 110052741B | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Piyush R Johari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053379016 PECOS PAC ID: 0446207898 Enrollment ID: I20050407000265 |
| Provider Name | Alice Mary Graham-brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104887207 PECOS PAC ID: 6305010141 Enrollment ID: I20111114000349 |
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