Provider Demographics
NPI:1356823165
Name:DIRIENZO, KAREN M (LICSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:DIRIENZO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-1424
Mailing Address - Country:US
Mailing Address - Phone:781-273-1236
Mailing Address - Fax:
Practice Address - Street 1:6 WILDWOOD LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-1424
Practice Address - Country:US
Practice Address - Phone:781-273-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1077031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical