MITCHELL I CLIONSKY (NPI# 1083772537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083772537 |
| Entity Type | Individual |
| Full Name | MITCHELL I CLIONSKY |
| Credential | PHD |
| Practice Address |
155 Maple Street Suite 203 Springfield MA 01105-1828 |
| Practice Telephone | 4137343331 |
| Practice Fax Number | 4137391652 |
| Mailing Telephone | 4137343331 |
| Mailing Fax Number | 4137391652 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 2113 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS OF MA | W02301 | 01 | |
| HEALTH NEW ENGLAND | 11365 | 01 | |
| CHAMPUS | 5024760 | 01 | |
| TUFTS | 734079 | 01 |
| Street Address |
155 MAPLE STREET SUITE 203 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01105-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518032382 | Elizabeth Wexford | Psychologist | 155 Maple Street, Suite 203, Springfield, MA 01105-1828 | 2006-11-21 |
| 1619042496 | The Add Center of Western Massachusetts | Clinical Neuropsychologist | 155 Maple Street, Suite 203, Springfield, MA 01105-1828 | 2006-11-21 |
| 1861567638 | Lynn I Newlove | Psychologist | 155 Maple Street, Suite 203, Springfield, MA 01105-1828 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881166551 | Rachael Ellen Buckley | Behavioral Analyst | 1 Federal Street, Stccac Technical Park, Building 101, 1 East-3, Springfield, MA 01105 | 2018-12-19 |
| 1902380017 | Choice Recovery Coaching Inc. | Peer Specialist | 155 Maple St., Suite 305, Springfield, MA 01105 | 2018-09-24 |
| 1508351107 | Breanna Wardwell | Psychologist | 110 Maple St Ste 110, Springfield, MA 01105 | 2018-06-26 |
| 1538689831 | Ruthie May Therrien | Counselor | 140 High St #230, Springfield, MA 01105 | 2017-06-27 |
| 1124483771 | Jane Danette Smith | Counselor | 15 Mulberry Street, Phoenix House, Springfield, MA 01105 | 2015-12-28 |
| 1043682008 | Nancy Hernandez | Social Worker | 140 High Street Suite 230, South Bay Mental Health Springfield Clinic, Springfield, MA 01105 | 2015-10-29 |
| 1205204567 | Yarelis Aquino | Social Worker | 511 Eastt Columbus Ave, Springfield, MA 01105 | 2015-09-03 |
| 1417376419 | Wanda I Perez | Student in an Organized Health Care Education/Training Program | 367 Pine Street, Springfield, MA 01105 | 2014-04-08 |
| 1275968778 | Elizabeth Catherine Grey | Social Worker | 155 Maple St Ste 304, Springfield, MA 01105 | 2013-09-04 |
| 1891033148 | Carol Ouellette | Counselor | 511 East Columbus Avenue, Springfield, MA 01105 | 2013-01-22 |
| Find all providers in zip 01105 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194850859 | Murrell Counseling Service, LLC | Clinical Neuropsychologist | 2200 E Sunshine St Ste 312, Springfield, MO 65804-1883 | 2007-02-22 |
| 1356424972 | Frederick A Ulam IIi | Clinical Neuropsychologist | 516 E Catalpa St, Springfield, MO 65807-1614 | 2006-10-24 |
| 1205864998 | Deborah A. Fein | Clinical Neuropsychologist | 155 Maple St, Suite 407, Springfield, MA 01105-1828 | 2006-06-29 |
| 1346294493 | Michelle Papka Puri | Clinical Neuropsychologist | 195 Mountain Ave, Springfield, NJ 07081-1755 | 2006-05-22 |
| 1306843735 | Michael Whetstone | Clinical Neuropsychologist | 2115 S Fremont Ave Ste 3000, Springfield, MO 65804-2215 | 2005-06-30 |
| 1437773454 | Alphonso Smith | Clinical Neuropsychologist | 319 E Madison St Fl 3, Springfield, IL 62701-1035 | 2020-06-05 |
| 1093349888 | Lindsay Nguyen Vo | Clinical Neuropsychologist | 1300 E Bradford Pkwy, Springfield, MO 65804-4264 | 2020-03-02 |
| 1992289425 | Jacob Levi Priluck | Clinical Neuropsychologist | 6120 Brandon Ave, Springfield, VA 22150-2522 | 2018-09-20 |
| 1295230431 | Jessica Di Marco | Clinical Neuropsychologist | 29 Ridgewood Rd, Springfield, VT 05156-3060 | 2018-03-29 |
| 1205355542 | Jessica Degaetano | Clinical Neuropsychologist | 195 Mountain Ave, Springfield, NJ 07081-1755 | 2017-09-19 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01105 |
Please comment or provide details below to improve the information on MITCHELL I CLIONSKY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.