Healthcare Provider Details

I. General information

NPI: 1952868705
Provider Name (Legal Business Name): LEONICE DE OLIVEIRA FERREIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SOMERSET ST
BELMONT MA
02478-2003
US

IV. Provider business mailing address

5 SOMERSET ST
BELMONT MA
02478-2003
US

V. Phone/Fax

Practice location:
  • Phone: 781-454-8499
  • Fax:
Mailing address:
  • Phone: 781-454-8499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28129
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number120704
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70094565
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13007
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10001611
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number19845
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number94080
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: