Provider Demographics
NPI:1346640638
Name:DI FILIPPO, KRISTEN (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:DI FILIPPO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PROSPECT ST
Mailing Address - Street 2:APT 3
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418
Mailing Address - Country:US
Mailing Address - Phone:401-525-6875
Mailing Address - Fax:
Practice Address - Street 1:17 PROSPECT ST
Practice Address - Street 2:APT 3
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418
Practice Address - Country:US
Practice Address - Phone:401-525-6875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003436104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker