Provider Demographics
NPI:1568519619
Name:DIPIETRO, DORI MARIE (LCSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:DORI
Middle Name:MARIE
Last Name:DIPIETRO
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 W MONTE CRISTO AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3700
Mailing Address - Country:US
Mailing Address - Phone:606-565-0395
Mailing Address - Fax:602-896-1909
Practice Address - Street 1:10640 N 28TH DRIVE
Practice Address - Street 2:C-205 , #9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:606-565-0395
Practice Address - Fax:602-896-1909
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-100571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical