Healthcare Provider Details

I. General information

NPI: 1033018791
Provider Name (Legal Business Name): ANGELINA REILLY-PAPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 SAINT JOSEPH ST APT 401
FALL RIVER MA
02723-2021
US

IV. Provider business mailing address

56 SAINT JOSEPH ST APT 401
FALL RIVER MA
02723-2021
US

V. Phone/Fax

Practice location:
  • Phone: 774-623-9659
  • Fax:
Mailing address:
  • Phone: 774-623-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDP01109
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: