Healthcare Provider Details

I. General information

NPI: 1225993520
Provider Name (Legal Business Name): MONALISA PINA GOMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3057 ACUSHNET AVE
NEW BEDFORD MA
02745-3636
US

IV. Provider business mailing address

127 CHERRY ST APT 2
BROCKTON MA
02301-2615
US

V. Phone/Fax

Practice location:
  • Phone: 508-961-9127
  • Fax: 508-995-1281
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: