Healthcare Provider Details

I. General information

NPI: 1003732272
Provider Name (Legal Business Name): BENJAMIN MARK MONIZ MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 ORCHARD ST STE 202
NEW BEDFORD MA
02744-1052
US

IV. Provider business mailing address

191 PLYMOUTH ST
NEW BEDFORD MA
02740-1423
US

V. Phone/Fax

Practice location:
  • Phone: 508-887-3731
  • Fax:
Mailing address:
  • Phone: 508-951-9436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: