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General NPI Number Information
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NPI Number | 1134436900
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Entity Type | Organization
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Legal Business Name | ANDREA DIFILIPPO, LICSW & ASSOCIATES, INC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 119 WAREHAM ROAD, SUITE 104
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City | MARION
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State | MA
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Zip | 02738
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Country | US
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Telephone | 508-748-3131
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Fax | 508-748-3197
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Provider Business Mailing Address
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Address Line | 82 COUNTY ROAD PMB #1
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City | MATTAPOISETT
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State | MA
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Zip | 02739-1651
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Country | US
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Telephone | 508-965-9657
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Fax | 508-748-1144
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA CELESTE DIFILIPPO
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Credential | LICSW
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Telephone | 508-965-9657
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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 | 108049
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License Number State | MA
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