Provider Demographics
NPI:1659536936
Name:FERREIRA-MACHADO, MICHELLE GOMES (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GOMES
Last Name:FERREIRA-MACHADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MURRAY ST.
Mailing Address - Street 2:FAMILY SERVICES OF GREATER WATEBURY
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710
Mailing Address - Country:US
Mailing Address - Phone:203-756-8317
Mailing Address - Fax:
Practice Address - Street 1:34 MURRAY ST.
Practice Address - Street 2:FAMILY SERVICES OF GREATER WATEBURY
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710
Practice Address - Country:US
Practice Address - Phone:203-756-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004068284Medicaid