Provider Demographics
NPI:1528113354
Name:JIMERSON, PAUL H (MA COUNS&PSYCH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:JIMERSON
Suffix:
Gender:M
Credentials:MA COUNS&PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1403
Mailing Address - Country:US
Mailing Address - Phone:413-320-7510
Mailing Address - Fax:
Practice Address - Street 1:40 BOBALA RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-9632
Practice Address - Country:US
Practice Address - Phone:413-536-5473
Practice Address - Fax:413-536-2760
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health