Provider Demographics
NPI:1730781584
Name:THE CENTER FOR RESILIENCE, PC
Entity type:Organization
Organization Name:THE CENTER FOR RESILIENCE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRODIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-687-8239
Mailing Address - Street 1:30 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-1813
Mailing Address - Country:US
Mailing Address - Phone:413-437-0875
Mailing Address - Fax:
Practice Address - Street 1:30 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-1813
Practice Address - Country:US
Practice Address - Phone:413-687-8239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health