Provider Demographics
NPI:1447723788
Name:GOMES OKIDE, VANDA MARLENE (MSW)
Entity type:Individual
Prefix:
First Name:VANDA
Middle Name:MARLENE
Last Name:GOMES OKIDE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:VANDA
Other - Middle Name:MARLENE
Other - Last Name:GOMES-DEPINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:3057 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-3636
Mailing Address - Country:US
Mailing Address - Phone:508-742-1024
Mailing Address - Fax:508-995-1281
Practice Address - Street 1:3057 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-3636
Practice Address - Country:US
Practice Address - Phone:508-742-1024
Practice Address - Fax:508-995-1281
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty