Provider Demographics
NPI:1861783045
Name:SOARES, FLORIPES G (MSW)
Entity type:Individual
Prefix:
First Name:FLORIPES
Middle Name:G
Last Name:SOARES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MORAINE STREET
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:508-468-5089
Mailing Address - Fax:508-588-6840
Practice Address - Street 1:141 MORAINE ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3626
Practice Address - Country:US
Practice Address - Phone:508-468-5089
Practice Address - Fax:508-588-6840
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health