Provider Demographics
NPI:1851113310
Name:ANDRADE, ROBERTO MEDEIROS
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:MEDEIROS
Last Name:ANDRADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-2729
Mailing Address - Country:US
Mailing Address - Phone:508-642-4376
Mailing Address - Fax:
Practice Address - Street 1:21 FATHER DEVALLES BLVD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1519
Practice Address - Country:US
Practice Address - Phone:978-408-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health