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General NPI Number Information
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NPI Number | 1093065690
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Entity Type | Individual
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Provider Name | ADESHOLLA LEANN GIONET MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 131 W MAIN ST
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City | ORANGE
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State | MA
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Zip | 01364-1150
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Country | US
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Telephone | 413-372-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MUSKETT DRIVE
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City | TEMPLETON
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State | MA
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Zip | 01468-1569
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Country | US
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Telephone | 978-939-8383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 220675
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 120680
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License Number State | MA
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