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General NPI Number Information
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NPI Number | 1669609319
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Entity Type | Individual
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Provider Name | JOSE NIEVES LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 97 CENTRAL ST SUITE 207
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City | LOWELL
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State | MA
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Zip | 01852-1917
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Country | US
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Telephone | 978-735-3529
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Fax | 978-452-0054
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Provider Business Mailing Address
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Address Line | 97 CENTRAL ST SUITE 207
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City | LOWELL
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State | MA
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Zip | 01852-1917
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Country | US
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Telephone | 978-735-3529
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Fax | 978-452-0054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 218474
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License Number State | MA
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