Healthcare Provider Details

I. General information

NPI: 1740106376
Provider Name (Legal Business Name): KRYSTAL DUBE-GASPAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRYSTAL DUBE

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 OREGON ST
FALL RIVER MA
02720-2895
US

IV. Provider business mailing address

68 OREGON ST APT 3
FALL RIVER MA
02720-2895
US

V. Phone/Fax

Practice location:
  • Phone: 617-519-4404
  • Fax:
Mailing address:
  • Phone: 617-519-4404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW231050
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: