Provider Demographics
NPI:1952295073
Name:ESTES, MARK JAMES
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:JAMES
Last Name:ESTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 GRATTAN ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1284
Mailing Address - Country:US
Mailing Address - Phone:413-320-1380
Mailing Address - Fax:
Practice Address - Street 1:94 N ELM ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1647
Practice Address - Country:US
Practice Address - Phone:413-540-1234
Practice Address - Fax:413-538-5169
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor