Healthcare Provider Details

I. General information

NPI: 1700815040
Provider Name (Legal Business Name): CATHERINE L LACOSTE-HAMEL APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 DAVOL ST ARBOUR COUNSELING SERVICES
FALL RIVER MA
02720
US

IV. Provider business mailing address

1082 DAVOL ST ARBOUR COUNSELING SERVICES
FALL RIVER MA
02720
US

V. Phone/Fax

Practice location:
  • Phone: 508-678-2388
  • Fax:
Mailing address:
  • Phone: 508-678-2388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberPNS00006
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number003703
License Number StateCT

VII. Legacy identifiers

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

# 1
Identifier30172-5
Identifier TypeOTHER
Identifier StateRI
Identifier IssuerBLUE CROSS
# 2
Identifier407841
Identifier TypeOTHER
Identifier StateRI
Identifier IssuerBLUE CHIP
# 3
Identifier004037032
Identifier TypeMEDICAID
Identifier StateCT
Identifier Issuer
# 4
Identifier62-01668
Identifier TypeOTHER
Identifier StateRI
Identifier IssuerUNITED BEHAVIORAL HEALTH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: