Provider Demographics
NPI:1073011664
Name:CABRAL, JERE NICHOLE
Entity Type:Individual
Prefix:
First Name:JERE
Middle Name:NICHOLE
Last Name:CABRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JERE
Other - Middle Name:NICHOLE
Other - Last Name:MACMURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 CASE AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-4156
Mailing Address - Country:US
Mailing Address - Phone:774-901-4800
Mailing Address - Fax:
Practice Address - Street 1:70 CASE AVE STE 1
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-4156
Practice Address - Country:US
Practice Address - Phone:774-901-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1253651041C0700X
RI036691041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical