=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124926753
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MIGUEL ARCANJO FONTES JR. LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2026
-----------------------------------------------------
Last Update Date | 10/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 DONALDS WAY STE 200
-----------------------------------------------------
City | EAST BRIDGEWATER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02333-1478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-894-0423
-----------------------------------------------------
Fax | 508-941-6134
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 94 WHITMAN ST
-----------------------------------------------------
City | EAST BRIDGEWATER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02333-1922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-894-0423
-----------------------------------------------------
Fax | 508-941-6134
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | LCSW2120814
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------