Healthcare Provider Details

I. General information

NPI: 1700135779
Provider Name (Legal Business Name): ALFRED WILLIAM BAPTISTA JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 HIGHLAND AVE
FALL RIVER MA
02720-4508
US

IV. Provider business mailing address

35 W WEIR ST
TAUNTON MA
02780-4620
US

V. Phone/Fax

Practice location:
  • Phone: 508-235-3427
  • Fax:
Mailing address:
  • Phone: 508-822-0529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number202957
License Number StateMA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: