PHALNARITH BA OUT REACH WORKER NPI 1114064656

NPI Information

NPI: 1114064656
Provider Name: PHALNARITH BA, OUT REACH WORKER
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
265 BEACH ST
REVERE, MA
ZIP 02151
Phone: (617) 912-7732
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Phalnarith Ba, OUT REACH WORKER is a mental health counselor in Revere, MA. Phalnarith Ba, OUT REACH WORKER NPI is 1114064656. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

265 BEACH ST
REVERE, MA
ZIP 02151-131
Phone: (617) 912-7732
Fax: (781) 286-5636

The enumeration date for this NPI number is 2/1/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes
2	171R00000X	Interpreter				X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1301659	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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