Individual provider · Type 1 NPI
Edward Justin Modestino, PhD
Mental Health Counselor · South Easton, MA
NPI number
1467064972
Active
Practice location
8 Meadowbrook Ln
South Easton, MA 02375-1289
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LMHC10002001 (MA) |
| Mental Health Counselor | 101YM0800X | MHC01717 (RI) |
Mental Health Counselor: Definition to come...
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About NPI 1467064972
Edward Justin Modestino, PhD's National Provider Identifier is 1467064972, issued on Aug 18, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in South Easton, MA. The record was last updated on Jun 16, 2026.