Healthcare Provider Details
I. General information
NPI: 1366533317
Provider Name (Legal Business Name): MARIE GASPAR LMFT, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1082 DAVOL ST
FALL RIVER MA
02720-1124
US
IV. Provider business mailing address
1082 DAVOL ST
FALL RIVER MA
02720-1124
US
V. Phone/Fax
- Phone: 508-678-2833
- Fax:
- Phone: 508-678-2833
- Fax: 508-675-9640
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 7951 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | LMFT00063 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: