Provider Demographics
NPI:1275941619
Name:JOAN GIALLORENZO, LMHC
Entity Type:Organization
Organization Name:JOAN GIALLORENZO, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIALLORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-214-1119
Mailing Address - Street 1:11 MIDDLESEX AVE
Mailing Address - Street 2:UNIT 10A
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 MIDDLESEX AVE
Practice Address - Street 2:UNIT 10A
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2771
Practice Address - Country:US
Practice Address - Phone:781-214-1119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7193261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)