Healthcare Provider Details

I. General information

NPI: 1114739554
Provider Name (Legal Business Name): ALYSSA LOPES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 N MAIN ST STE 205
FALL RIVER MA
02720-2972
US

IV. Provider business mailing address

114 PARK ST
NEW BEDFORD MA
02740-3557
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-1060
  • Fax:
Mailing address:
  • Phone: 508-558-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: