Healthcare Provider Details

I. General information

NPI: 1194638445
Provider Name (Legal Business Name): MR. PATRICK LUIZ PEREIRA-PIRES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PATRICK PIRES

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BLAIR TER
PEABODY MA
01960-5105
US

IV. Provider business mailing address

3 BLAIR TER
PEABODY MA
01960-5105
US

V. Phone/Fax

Practice location:
  • Phone: 781-710-9437
  • Fax:
Mailing address:
  • Phone: 781-710-9437
  • 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: