Basic Information
Provider Information
NPI: 1033580006
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUEVAS
FirstName: KATHY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherCredential:  
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Mailing Information
Address1: 26 ROLLING GREEN DR APT H
Address2:  
City: FALL RIVER
State: MA
PostalCode: 027207850
CountryCode: US
TelephoneNumber: 7742403910
FaxNumber:  
Practice Location
Address1: 35 SUMMER ST
Address2:  
City: TAUNTON
State: MA
PostalCode: 027803469
CountryCode: US
TelephoneNumber: 5088802835
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/15/2015
LastUpdateDate: 10/15/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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