Healthcare Provider Details
I. General information
NPI: 1972369478
Provider Name (Legal Business Name): SARA RODRIGUES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 LANGLEY ST
FALL RIVER MA
02720-7302
US
IV. Provider business mailing address
830 LANGLEY ST
FALL RIVER MA
02720-7302
US
V. Phone/Fax
- Phone: 508-942-9948
- Fax:
- Phone: 508-942-9948
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social 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: DR.
SARA
O
RODRIGUES
Title or Position: OWNER/MANAGER
Credential: LICSW
Phone: 508-942-9948