Organization
DVA
Active
Other names
VAMC Northampton
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE CAVANAUGH (CREDENTILING COORDINATOR)
(413) 584-4040
Entity
Organization
Contact information
Practice address
421 N MAIN ST, VA MEDICAL CENTER, LEEDS, MA 01053-9764
(413) 582-3038
Mailing address
421 NORTH MAIN STREET, VA MEDICAL CENTER, LEEDS, MA 01053-9764
(413) 582-3038
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
002701
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002701
LCSW
CT
Enumeration date
07/11/2006
Last updated
08/22/2020
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