MEDICARE: KIRA ALEXIS FERNANDES LMHC

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	LMHC10001765	MA
2	101YM0800X	Mental Health Counselor	CC8280	ME

General Provider Information

NPI Number	:	1740655950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRA ALEXIS FERNANDES LMHC

Provider Business Mailing Address
First Line	:	4 COURT ST STE A309
Second Line	:
City	:	TAUNTON
State	:	MA
Zip	:	02780-3218
Country	:	US
Telephone Number	:	508-622-5013
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 COURT ST STE A309
Second Line	:
City	:	TAUNTON
State	:	MA
Zip	:	02780-3218
Country	:	US
Telephone Number	:	508-622-5013
Fax Number	:

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

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	05/18/2026

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