Provider Demographics
NPI:1386066579
Name:CLINICAL AND SUPPORT OPTIONS
Entity type:Organization
Organization Name:CLINICAL AND SUPPORT OPTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-737-9544
Mailing Address - Street 1:877 SOUTH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8242
Mailing Address - Country:US
Mailing Address - Phone:413-235-5656
Mailing Address - Fax:413-499-6572
Practice Address - Street 1:877 SOUTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8242
Practice Address - Country:US
Practice Address - Phone:413-235-5656
Practice Address - Fax:413-499-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1831265115OtherNPI NUMBER