MEDICARE: PATRICK H BIVONA

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
1	101YM0800X	Mental Health Counselor	LCSW230071	MA

General Provider Information

NPI Number	:	1578498234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK H BIVONA

Provider Business Mailing Address
First Line	:	5 NAMSKAKET RD
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3202
Country	:	US
Telephone Number	:	774-332-3791
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 NAMSKAKET RD
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3202
Country	:	US
Telephone Number	:	774-332-3791
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ PATRICK H BIVONA ” Practice Location

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