| The Key Program, Incorporated. | |
|
576 State St Springfield MA 01109-4104 | |
| (413) 781-6485 | |
| (413) 788-6925 |
| Full Name | The Key Program, Incorporated. |
|---|---|
| Speciality | Clinic/Center |
| Location | 576 State St, Springfield, Massachusetts |
| Authorized Official Name and Position | William Lyttle (PRESIDENT) |
| Authorized Official Contact | 5088773690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Key Program, Incorporated. 576 State St Springfield MA 01109-4104 Ph: (413) 781-6485 | The Key Program, Incorporated. 576 State St Springfield MA 01109-4104 Ph: (413) 781-6485 |
| NPI Number | 1508908229 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 06/12/2013 |
| Medicare PECOS PAC ID | 1850286287 |
|---|---|
| Medicare Enrollment ID | O20040216000944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508908229 | NPI | - | NPPES |
| M17759 | Other | MA | BLUE CROSS BLUE SHIELD |
| 1306839 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 4389 (Massachusetts) | Primary |
| Provider Name | Lili A Gottfried |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215902390 PECOS PAC ID: 1254306251 Enrollment ID: I20040901001041 |
| Provider Name | Lucy L Munson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619020351 PECOS PAC ID: 7810091329 Enrollment ID: I20070322000232 |
| Provider Name | Norah K Hass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154499424 PECOS PAC ID: 3971609827 Enrollment ID: I20070509000479 |
| Provider Name | Patricia Conway |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457410706 PECOS PAC ID: 0244429918 Enrollment ID: I20110111000685 |
| Provider Name | Angeline Hynes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992828032 PECOS PAC ID: 0749439511 Enrollment ID: I20121011000461 |
| Provider Name | Carolyn Cote |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316273006 PECOS PAC ID: 3678830387 Enrollment ID: I20171206000376 |
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