Provider Demographics
NPI:1134508690
Name:MEJIAS, WILBERTO SR (CLINICIAN)
Entity Type:Individual
Prefix:
First Name:WILBERTO
Middle Name:
Last Name:MEJIAS
Suffix:SR
Gender:M
Credentials:CLINICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BROADWAY
Mailing Address - Street 2:# 372
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-8000
Mailing Address - Country:US
Mailing Address - Phone:978-606-9072
Mailing Address - Fax:
Practice Address - Street 1:272 BROADWAY
Practice Address - Street 2:# 372
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-8000
Practice Address - Country:US
Practice Address - Phone:978-606-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor