Organization
JAMES EDMONSTONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WALKER EDMONSTONE LICSW (LICENSED INDEPENDENT CLINICAL SOC)
(413) 586-0098
Entity
Organization
Contact information
Practice address
78 MAINST., SUITE 404, NORTHAMPTON, MA 01060
(413) 586-0098
(413) 586-0083
Mailing address
78 MAINST., SUITE 404, NORTHAMPTON, MA 01060
(413) 586-0098
(413) 586-0083
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
103484
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P30136
MEDICARE PTAN
MA
Enumeration date
02/25/2016
Last updated
02/25/2016
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