Diaz, Jacelyn

Diaz, Jacelyn is an sole proprietor health care provider with primary practice located at 319 Beech St , Holyoke MA 01040-3968. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Diaz, Jacelyn can be contacted via phone (413) 540-1115.

Contact Information

Primary practice address
319 Beech St Holyoke MA 01040-3968
Phone: (413) 540-1115
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1144842881
LBN Legal business name Diaz, Jacelyn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2020
Last updated May 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144842881 NPPES
Massachusetts MEDICAID 042174657

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