Provider Demographics
NPI:1083101885
Name:D'AMICO, ROSE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3524
Mailing Address - Country:US
Mailing Address - Phone:203-610-2954
Mailing Address - Fax:
Practice Address - Street 1:119 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3524
Practice Address - Country:US
Practice Address - Phone:203-610-2954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical