George D Affonso, LADC I, CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Plymouth, MA

NPI 1013655232 · NPPES record last updated Jun 1, 2022

Key facts

NPI
1013655232
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
16860 (MA)
Practice address
60 Cherry St
Plymouth, MA 02360-4466
Phone
(508) 746-6654
Fax
(508) 746-2433
NPI assigned
May 26, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor House, Inc. Addiction (Substance Use Disorder) Past
since May 29, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16860 MA Yes

Addresses

Primary practice location

60 Cherry St
Plymouth, MA 02360-4466

Mailing address

11A Standish Ave
Plymouth, MA 02360-4145
Phone (501) 626-8050

Other providers in Plymouth, MA

All providers in Plymouth, MA · Addiction (Substance Use Disorder) Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.