Provider Demographics
NPI:1619374196
Name:NASCIMENTO, NELMA
Entity Type:Individual
Prefix:
First Name:NELMA
Middle Name:
Last Name:NASCIMENTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 TAUNTON GRN
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3251
Mailing Address - Country:US
Mailing Address - Phone:774-406-4620
Mailing Address - Fax:
Practice Address - Street 1:39 TAUNTON GRN
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3251
Practice Address - Country:US
Practice Address - Phone:774-406-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303295Medicaid
MAM18463OtherBLUE CROSS BLUE SHIELD
MA1307576Medicaid
MAY10086Medicare PIN