Provider Demographics
NPI:1518348341
Name:ORTA, CECILIO ORLANDO JR
Entity Type:Individual
Prefix:MR
First Name:CECILIO
Middle Name:ORLANDO
Last Name:ORTA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 BROADWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-3470
Mailing Address - Country:US
Mailing Address - Phone:617-843-0886
Mailing Address - Fax:
Practice Address - Street 1:391 BROADWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-3470
Practice Address - Country:US
Practice Address - Phone:617-843-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor