Individual
MS. DANA DECILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHC, LPC
Contact information
Practice address
27 NAEK ROAD, VERNON, CT 06066
(413) 537-4284
Mailing address
25 SOUTH VIEW DRIVE, SOUTHWICK, MA 01077
(413) 537-4284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5595
MA
101YP2500X
Professional Counselor
Primary
1596
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300010
MBHP
MA
05
—
1300881
—
MA
Enumeration date
04/07/2007
Last updated
01/22/2013
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