Doctor Name: | ROBERTO ELPIDIO AGRAIT |
NPI Number: | 1255341129 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | LMHC # 1031 |
Business Practice Address: | 116 Pleasant St 3307 Easthampton, MA - 010272752 |
Business Phone Number: | 4133354647 |
Business Fax Number: | |
Mailing Address: | 116 Pleasant St, 3307 EASTHAMPTON |
State: | MA |
Postal Code: | 010272752 |
Phone Number: | 4133354647 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LMHC # 1031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |