Provider Demographics
NPI:1063921989
Name:DEBARROS, ORZENIRA DIAS (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ORZENIRA
Middle Name:DIAS
Last Name:DEBARROS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:ORZENIRA
Other - Middle Name:DIAS
Other - Last Name:DEBARROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ORZENIRA DIAS GOMES
Mailing Address - Street 1:118 UNION AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8208
Mailing Address - Country:US
Mailing Address - Phone:508-433-0384
Mailing Address - Fax:
Practice Address - Street 1:118 UNION AVE STE 17
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8208
Practice Address - Country:US
Practice Address - Phone:508-433-0384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1740336858101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042389659Medicaid