Healthcare Provider Details

I. General information

NPI: 1720116205
Provider Name (Legal Business Name): CATHOLIC SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 BAY ST
FALL RIVER MA
02724-1216
US

IV. Provider business mailing address

1600 BAY ST
FALL RIVER MA
02724-1216
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-7337
  • Fax: 508-984-1667
Mailing address:
  • Phone: 508-997-7337
  • Fax: 508-984-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1018754
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. MARIA C. PEREIRA
Title or Position: COUNSELING COORDINATOR
Credential: MSW
Phone: 508-997-7337