Healthcare Provider Details

I. General information

NPI: 1952138661
Provider Name (Legal Business Name): STEVEN ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON ST
TAUNTON MA
02780-5293
US

IV. Provider business mailing address

167 POINT ST
PROVIDENCE RI
02903-4771
US

V. Phone/Fax

Practice location:
  • Phone: 508-828-9116
  • Fax:
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: