Organization
Psychiatry and Primary Care
Provider's NPPES record last updated: August 5, 2026
Overview
- Entity Type
- Organization
- NPI
- 1053174235
- Primary Specialty
- Nurse Practitioner — Psychiatric/Mental Health
- Practice Location
- Longmeadow, Massachusetts
- Organization Subpart
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 2:14 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Psychiatric/Mental Health
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LP0808X Psychologist
Prescribing (Medical)
Behavioral Health & Social Service Providers
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
Taxonomy code 103TP0016XClinic/Center
Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities
Definition to come...
Taxonomy code 261QM0801X
Practice Locations
Practice Location
171 Dwight Rd Ste 103
Longmeadow, Massachusetts 01106-1768
Phone: (413) 200-0769
Record Information
- Enumeration Date
- January 31, 2024
- Provider's NPPES Record Last Updated
- August 5, 2026
- Certification Date
- August 5, 2026
- NPISignal NPPES Dataset
- August 2026
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