Provider Demographics
NPI:1104206374
Name:ANDREA C. DIFILIPPO, LICSW & ASSOCIATES
Entity Type:Organization
Organization Name:ANDREA C. DIFILIPPO, LICSW & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-748-3131
Mailing Address - Street 1:119 WAREHAM RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1178
Mailing Address - Country:US
Mailing Address - Phone:508-748-3131
Mailing Address - Fax:
Practice Address - Street 1:119 WAREHAM RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1178
Practice Address - Country:US
Practice Address - Phone:508-748-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1149531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty