| Angela Cardoso, Licsw Outpatient Therapist, Llc | |
|
6 Cabot Pl Ste 6 Stoughton MA 02072-4625 | |
| (508) 690-0830 | |
| Not Available |
| Full Name | Angela Cardoso, Licsw Outpatient Therapist, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6 Cabot Pl Ste 6, Stoughton, Massachusetts |
| Authorized Official Name and Position | Angela Cardoso Fontes (CEO) |
| Authorized Official Contact | 5086900830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Cardoso, Licsw Outpatient Therapist, Llc Po Box 4234 Brockton MA 02303-4234 Ph: () - | Angela Cardoso, Licsw Outpatient Therapist, Llc 6 Cabot Pl Ste 6 Stoughton MA 02072-4625 Ph: (508) 690-0830 |
| NPI Number | 1902513005 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/29/2022 |
| Medicare PECOS PAC ID | 1456795293 |
|---|---|
| Medicare Enrollment ID | O20240220001771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902513005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Angela S Cardoso-fontes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962650473 PECOS PAC ID: 3476873449 Enrollment ID: I20240220002616 |
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