Tina A Serpa, LADC-I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

19541 Issued in MA

Practice address

25W Old Westport Rd
Dartmouth, MA 02747-2513

Phone

(774) 930-7369

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1124151022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CENTURY DR",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027194217",
            "telephone_number": "774-930-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25W OLD WESTPORT RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027472513",
            "telephone_number": "774-930-7369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Ter Heun Dr",
            "address_purpose": "LOCATION",
            "city": "Falmouth",
            "state": "MA",
            "postal_code": "025402525",
            "country_code": "US",
            "telephone_number": "508-540-6550 x281",
            "fax_number": "508-540-7480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERPA",
        "first_name": "TINA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LADC-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "4024247",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "19541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Dartmouth, MA
• Providers in Dartmouth, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.