Provider Demographics
NPI:1104962653
Name:GOODFIELD, KATHLEEN ANNE (MSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANNE
Last Name:GOODFIELD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 BARDWELLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341-9751
Mailing Address - Country:US
Mailing Address - Phone:413-369-4459
Mailing Address - Fax:
Practice Address - Street 1:342 BIRNIE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1104
Practice Address - Country:US
Practice Address - Phone:413-439-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker