Basic Information
| Provider Information | |||||||||
| NPI: | 1588627152 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCKELVEY | ||||||||
| FirstName: | JOAN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8019 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 329 CONWAY ST | ||||||||
| Address2: | GREENFIELD HEALTH CENTER | ||||||||
| City: | GREENFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 013011526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137746301 | ||||||||
| FaxNumber: | 4137746528 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2006 | ||||||||
| LastUpdateDate: | 06/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1019747 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 30581 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 1294665 | 01 | MA | FALLON COMMUNITY HEALTH PLAN | OTHER | P07979 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 7793407 | 01 | MA | AETNA BEHAVIORAL HEALTH | OTHER | 2102207 | 01 | MA | CIGNA BEHAVIORAL HEALTH | OTHER | 800013338 | 01 | MA | RAILROAD MEDICARE | OTHER | 101974 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 455655000 | 01 | MA | MAGELLAN BEHAVIORAL HEALT | OTHER |