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General NPI Number Information
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NPI Number | 1811785256
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Entity Type | Organization
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Legal Business Name | DIVINELY GROUNDED
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 1213 PURCHASE ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-6694
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Country | US
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Telephone | 401-237-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 395 CHICAGO ST APT 3R
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City | FALL RIVER
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State | MA
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Zip | 02721-3526
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Country | US
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Telephone | 508-493-3984
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. KENDRA RAPOSO
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Credential | LICSW
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Telephone | 508-493-3984
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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 |
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License Number State |
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