Provider Demographics
NPI:1437639432
Name:WESTERN MASSACHUSETTS PSYCHIATRIC SPECIALISTS, LLC
Entity type:Organization
Organization Name:WESTERN MASSACHUSETTS PSYCHIATRIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP, CNS
Authorized Official - Phone:413-266-8326
Mailing Address - Street 1:175 DWIGHT RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1767
Mailing Address - Country:US
Mailing Address - Phone:413-266-8326
Mailing Address - Fax:413-317-7218
Practice Address - Street 1:175 DWIGHT RD STE 103
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1767
Practice Address - Country:US
Practice Address - Phone:413-266-8326
Practice Address - Fax:413-317-7218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-19
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty