Provider Demographics
NPI:1336545979
Name:UTZ, SAMUEL
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:UTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3642
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-3642
Mailing Address - Country:US
Mailing Address - Phone:413-344-8234
Mailing Address - Fax:413-961-5056
Practice Address - Street 1:106 WENDELL AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6930
Practice Address - Country:US
Practice Address - Phone:413-344-8234
Practice Address - Fax:413-961-5056
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor