Individual
DOMINGO NIEVES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLINICAL COORDINATOR
Contact information
Practice address
2225 MAIN ST., SPRINGFIELD, MA 01107
(413) 733-3488
(413) 731-7381
Mailing address
2257 MAIN ST, SPRINGFIELD, MA 01107-1905
(413) 733-3488
(413) 731-7381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301829
—
MA
05
—
3080010
—
NH
Enumeration date
07/13/2017
Last updated
07/13/2017
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