Provider Demographics
NPI:1093861056
Name:ISIDORIO, JAMES (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ISIDORIO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 GARRETT PL
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-6841
Mailing Address - Country:US
Mailing Address - Phone:781-588-3469
Mailing Address - Fax:
Practice Address - Street 1:664 STEVENS RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4701
Practice Address - Country:US
Practice Address - Phone:508-677-0304
Practice Address - Fax:508-678-9059
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health