Provider Demographics
NPI:1972138436
Name:PYRZANOWSKI-CHARLAND, PETE DANIEL (LICSW)
Entity type:Individual
Prefix:MR
First Name:PETE
Middle Name:DANIEL
Last Name:PYRZANOWSKI-CHARLAND
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:PYRZANOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:189 SPRINGFIELD RD TRLR 6
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1839
Mailing Address - Country:US
Mailing Address - Phone:781-697-8825
Mailing Address - Fax:
Practice Address - Street 1:189 SPRINGFIELD RD TRLR 6
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1839
Practice Address - Country:US
Practice Address - Phone:781-697-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1282341041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical