Healthcare Provider Details

I. General information

NPI: 1477198471
Provider Name (Legal Business Name): RL PSYCHOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LAUREL STREET
FALL RIVER MA
02724-3008
US

IV. Provider business mailing address

150 LAUREL STREET
FALL RIVER MA
02724-3008
US

V. Phone/Fax

Practice location:
  • Phone: 508-345-9398
  • Fax: 508-617-9204
Mailing address:
  • Phone: 508-345-9398
  • Fax: 508-617-9204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1073715074
Identifier TypeOTHER
Identifier State
Identifier IssuerNPI

VIII. Authorized Official

Name: MR. RUI M LIMA
Title or Position: PRINCIPAL OFFICER
Credential: LICSW
Phone: 508-345-9398