Healthcare Provider Details

I. General information

NPI: 1811214182
Provider Name (Legal Business Name): CINDY RODRIGUES MEDEIROS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY RODRIGUES MEDEIROS

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 N MAIN ST
FALL RIVER MA
02720-2983
US

IV. Provider business mailing address

65 HAMBLY RD
TIVERTON RI
02878-2103
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-1060
  • Fax:
Mailing address:
  • Phone: 401-573-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW117571
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: