Healthcare Provider Details

I. General information

NPI: 1669362240
Provider Name (Legal Business Name): BSW PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77R STATE RD
NORTH DARTMOUTH MA
02747-2919
US

IV. Provider business mailing address

77R STATE RD
NORTH DARTMOUTH MA
02747-2919
US

V. Phone/Fax

Practice location:
  • Phone: 508-817-7597
  • Fax: 774-202-2737
Mailing address:
  • Phone: 508-817-7597
  • Fax: 774-202-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AL RAPOSO
Title or Position: DIRECTOR
Credential:
Phone: 508-817-7597