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NPI Code Detail

MEDICARE: MR. JEFFREY R CODELLA M.S.ED.

MEDICARE: MR. JEFFREY R CODELLA M.S.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor5529MA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1003866021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY R CODELLA M.S.ED.
Provider Business Mailing Address
First Line : 1 WASHINGTON ST
Second Line :
City : TAUNTON
State : MA
Zip : 02780-5293
Country : US
Telephone Number : 508-828-9675
Fax Number : 508-821-2519
Provider Business Practice Location Address
First Line : 1 WASHINGTON ST
Second Line :
City : TAUNTON
State : MA
Zip : 02780-5293
Country : US
Telephone Number : 508-828-9675
Fax Number : 508-821-2519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 11/09/2025

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