Individual
PROF. JUAN CARLOS SANTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2155 MAIN ST, SPRINGFIELD, MA 01104-3301
(413) 736-0395
(413) 734-1651
Mailing address
147 NORMAN ST, WEST SPRINGFIELD, MA 01089-5003
(413) 736-8329
(413) 732-5362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3680
PR
103TC1900X
Counseling Psychologist
3680
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042622756
CCA
MA
01
—
1134107113
NHP
MA
01
—
12529
HNE
MA
05
—
1307576
—
MA
01
—
71756
TUFTS
MA
01
—
997303
NETWORK HEALTH
MA
Enumeration date
09/23/2013
Last updated
06/10/2016
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