Provider Demographics
NPI:1184724106
Name:HAFFEY, MARK D (EDD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:HAFFEY
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 WEST ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2936
Mailing Address - Country:US
Mailing Address - Phone:413-259-1654
Mailing Address - Fax:413-256-6476
Practice Address - Street 1:433 WEST ST
Practice Address - Street 2:SUITE 5
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2936
Practice Address - Country:US
Practice Address - Phone:413-259-1654
Practice Address - Fax:413-256-6476
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4415103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04532OtherBC/BS PROVIDER ID #
MA2034136OtherCIGNA HP PROVIDER ID #
MA339070OtherMAGELLAN PROVIDER ID #
MA004415OtherTUFTS HEALTH PLAN
MA042945394OtherUBH PROVIDER ID #
MA24262OtherHEALTH NEW ENGLAND PROVID
MA4415OtherLICD PSYCHOLOGIST PROVIDE
MAW04532OtherBC/BS PROVIDER ID #