Provider Demographics
NPI:1942414826
Name:MATTOS, BERINA CONCEICAO (LMHC, LSW)
Entity Type:Individual
Prefix:MRS
First Name:BERINA
Middle Name:CONCEICAO
Last Name:MATTOS
Suffix:
Gender:F
Credentials:LMHC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3015
Mailing Address - Country:US
Mailing Address - Phone:774-294-5722
Mailing Address - Fax:774-294-5724
Practice Address - Street 1:110 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2813
Practice Address - Country:US
Practice Address - Phone:508-287-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 104100000X, 106H00000X, 103K00000X
MA7650101YM0800X
MA313055104100000X
RIMHC00501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst