Healthcare Provider Details

I. General information

NPI: 1043402647
Provider Name (Legal Business Name): MICHAEL A RODRIGUES CADC, PGS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

IV. Provider business mailing address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-5222
  • Fax: 508-673-3182
Mailing address:
  • Phone: 508-679-5222
  • Fax: 508-673-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1331AD
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: