MEDICARE: MS. ELAINE M DOS SANTOS LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	122832	MA

General Provider Information

NPI Number	:	1558768622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE M DOS SANTOS LICSW

Provider Business Mailing Address
First Line	:	878 WASHINGTON ST # 1182
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-7547
Country	:	US
Telephone Number	:	774-254-0877
Fax Number	:

Provider Business Practice Location Address
First Line	:	878 WASHINGTON ST # 1182
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-7547
Country	:	US
Telephone Number	:	774-254-0877
Fax Number	:	774-254-0877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2014
Last Update Date	:	02/19/2026

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