MEDICARE: JAMES PEREIRA MA, CAGS, L.M.H.C

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

General Provider Information

NPI Number	:	1881629665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES PEREIRA MA, CAGS, L.M.H.C

Provider Business Mailing Address
First Line	:	12 TURNER AVE
Second Line	:
City	:	FAIRHAVEN
State	:	MA
Zip	:	02719-3612
Country	:	US
Telephone Number	:	774-473-0067
Fax Number	:	508-828-9146

Provider Business Practice Location Address
First Line	:	1 WASHINGTON ST
Second Line	:
City	:	TAUNTON
State	:	MA
Zip	:	02780-3960
Country	:	US
Telephone Number	:	508-828-9116
Fax Number	:	508-828-9146

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/10/2015

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