Provider Demographics
NPI:1669724738
Name:FREITAS, MARIA ALICE (MSW LICSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ALICE
Last Name:FREITAS
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25R OLD WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-2513
Mailing Address - Country:US
Mailing Address - Phone:508-994-7614
Mailing Address - Fax:508-994-7615
Practice Address - Street 1:25R OLD WESTPORT RD
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2513
Practice Address - Country:US
Practice Address - Phone:508-994-7614
Practice Address - Fax:508-994-7615
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10300341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical