Healthcare Provider Details
I. General information
NPI: 1144231572
Provider Name (Legal Business Name): PATRICIA ELLEN GARBER M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
386 STANLEY ST STANLEY STREET TREATMENT AND RESOURCES
FALL RIVER MA
02720
US
IV. Provider business mailing address
101 LONG PASTURE WAY
TIVERTON RI
02878-4825
US
V. Phone/Fax
- Phone: 508-324-3549
- Fax: 508-679-3678
- Phone: 401-816-0072
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 114588 |
| License Number State | MA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 000000008464 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | BMC MASS HEALTH |
| # 2 | |
| Identifier | 725921 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | TUFTS |
| # 3 | |
| Identifier | TAX ID |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | HCVM |
| # 4 | |
| Identifier | 1306685 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | MBHP - MASS HEALTH |
| # 5 | |
| Identifier | 1002950 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | BEACON |
| # 6 | |
| Identifier | 1306685 |
| Identifier Type | MEDICAID |
| Identifier State | MA |
| Identifier Issuer | |
| # 7 | |
| Identifier | A005312/008588 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | VALUE OPTIONS BC/BS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: