Healthcare Provider Details

I. General information

NPI: 1477759074
Provider Name (Legal Business Name): JENNIFER SUZANNE RAPOSO LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 HILLSIDE ST
FALL RIVER MA
02720-5211
US

IV. Provider business mailing address

49 HILLSIDE ST
FALL RIVER MA
02720-5211
US

V. Phone/Fax

Practice location:
  • Phone: 508-235-7277
  • Fax: 508-235-7345
Mailing address:
  • Phone: 508-235-7200
  • Fax: 508-235-7350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114544
License Number StateMA

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: