MEDICARE: DIANE J ZIPOLI LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	111008	MA

General Provider Information

NPI Number	:	1427538321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE J ZIPOLI LICSW

Provider Business Mailing Address
First Line	:	264 BAY STATE RD
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-1403
Country	:	US
Telephone Number	:	617-838-0109
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 BAY STATE RD
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-1403
Country	:	US
Telephone Number	:	617-838-0109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	07/03/2024

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Directions to “ DIANE J ZIPOLI LICSW” Practice Location

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