Provider Demographics
NPI:1417097544
Name:TSARNAS, CHARLES PETER (PHD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:PETER
Last Name:TSARNAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MAIN ST.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3256
Mailing Address - Country:US
Mailing Address - Phone:413-584-0585
Mailing Address - Fax:413-584-0515
Practice Address - Street 1:140 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3123
Practice Address - Country:US
Practice Address - Phone:413-584-0585
Practice Address - Fax:413-584-0515
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02856OtherBLUE CROSS BLUE SHIELD MA
MAW02856OtherBLUE CROSS BLUE SHIELD MA