Healthcare Provider Details

I. General information

NPI: 1447071097
Provider Name (Legal Business Name): JULIE MARIE BOLDUC DEFILIPPO PHD, MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. JULIE MARIE BOLDUC

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CENTRE ST STE HA-101
DANVERS MA
01923-1456
US

IV. Provider business mailing address

130 CENTRE ST STE HA-101
DANVERS MA
01923-1456
US

V. Phone/Fax

Practice location:
  • Phone: 978-500-6909
  • Fax:
Mailing address:
  • Phone: 978-500-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1140695
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number223719
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: