Healthcare Provider Details

I. General information

NPI: 1770497182
Provider Name (Legal Business Name): GIANNA ROSE DEFELICE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 STATE ST
NORTHAMPTON MA
01060-2265
US

IV. Provider business mailing address

142 NORTH ST
NORTHAMPTON MA
01060-2306
US

V. Phone/Fax

Practice location:
  • Phone: 413-701-1080
  • Fax:
Mailing address:
  • Phone: 559-301-5406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW2120631
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: