Provider Demographics
NPI:1609304732
Name:PARRA, MATTHEW J (MSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:J
Last Name:PARRA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 NEPONSET AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3169
Mailing Address - Country:US
Mailing Address - Phone:857-217-3700
Mailing Address - Fax:
Practice Address - Street 1:415 NEPONSET AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3168
Practice Address - Country:US
Practice Address - Phone:201-819-2982
Practice Address - Fax:201-819-2982
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical