NPIMap

Organization Active NPI

Mary Goncalo Group Practice

  • Health Psychologist
  • Fall River, MA
National Provider Identifier
1356890164
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health PsychologistTaxonomy code 103TH0004X
License
MG043357 Issued in MA
Legal business name
MARY GONCALO GROUP PRACTICE
Practice address
101 Sullivan Dr
Fall River, MA 02721-6812
Phone
(774) 644-5629
Fax
(508) 678-8100
NPI assigned
Sep 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Authorized official

Name
Ms. Mary Goncalo, RNCSNPI 1316032774
Title
Owner
Phone
(774) 644-5629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0004X MG043357 MA Primary

Addresses

Primary practice location

101 Sullivan Dr
Fall River, MA 02721-6812

Mailing address

101 Sullivan Dr
Fall River, MA 02721-6812
Phone (774) 644-5629

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1356890164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SULLIVAN DR",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027216812",
            "telephone_number": "774-644-5629",
            "fax_number": "508-678-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SULLIVAN DR",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027216812",
            "telephone_number": "774-644-5629",
            "fax_number": "508-678-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY GONCALO GROUP PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "GONCALO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-644-5629",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RNCS"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health",
            "state": "MA",
            "license": "MG043357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.