Healthcare Provider Details

I. General information

NPI: 1720741689
Provider Name (Legal Business Name): LARYZZA CARDOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3088 CRANBERRY HWY STE A
EAST WAREHAM MA
02538-4800
US

IV. Provider business mailing address

PO BOX 806
EAST WAREHAM MA
02538-0806
US

V. Phone/Fax

Practice location:
  • Phone: 508-514-7727
  • Fax: 508-295-3781
Mailing address:
  • Phone: 508-317-7580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: