MEDICARE: MRS. BERINA CONCEICAO MATTOS BCBA, LABA, LMHC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor	MHC00501	RI
3	101YM0800X	Mental Health Counselor
4	103K00000X	Behavior Analyst
5	104100000X	Social Worker	313055	MA
6	106H00000X	Marriage & Family Therapist
7	101YM0800X	Mental Health Counselor	7650	MA

General Provider Information

NPI Number	:	1942414826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BERINA CONCEICAO MATTOS BCBA, LABA, LMHC

Provider Business Mailing Address
First Line	:	170 PLEASANT ST
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02721-3015
Country	:	US
Telephone Number	:	774-294-5722
Fax Number	:	774-294-5724

Provider Business Practice Location Address
First Line	:	170 PLEASANT ST STE 100
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02721-3015
Country	:	US
Telephone Number	:	508-287-7192
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	06/18/2025

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