MEDICARE: NEW BEDFORD COUNSELING GROUP, INC.

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	101YM0800X	Mental Health Counselor	3752	MA

General Provider Information

NPI Number	:	1659822989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEDFORD COUNSELING GROUP, INC.

Provider Business Mailing Address
First Line	:	306 MOUNT PLEASANT ST
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02746-1539
Country	:	US
Telephone Number	:	508-617-3643
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 MOUNT PLEASANT ST
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02746-1539
Country	:	US
Telephone Number	:	508-617-3643
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MICHAEL FRIAS
Credential	:
Telephone Number	:	508-617-3643

Provider Enumeration Date	:	10/21/2016
Last Update Date	:	10/21/2016

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