Healthcare Provider Details

I. General information

NPI: 1407700099
Provider Name (Legal Business Name): EMILY C. RICONDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 DERBY ST STE 6
HINGHAM MA
02043-3718
US

IV. Provider business mailing address

200 QUARRY HILLS DR APT 1308
QUINCY MA
02169-3847
US

V. Phone/Fax

Practice location:
  • Phone: 781-740-9227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1120620
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: