Healthcare Provider Details

I. General information

NPI: 1245642040
Provider Name (Legal Business Name): NICOLE GABRIELLA DIGIOIA MSW, LICSW, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MEDICAL GROUP UNIT 7095, BOX 185, BLDG 865
APO AE
09824
US

IV. Provider business mailing address

39 MEDICAL GROUP UNIT 7095
APO AE
09824-0019
US

V. Phone/Fax

Practice location:
  • Phone: 314-676-3380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120517
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number120517
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120517
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: