Provider Demographics
NPI:1568745453
Name:DIFIORE, ANDREW (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:DIFIORE
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1941
Mailing Address - Country:US
Mailing Address - Phone:860-748-2331
Mailing Address - Fax:
Practice Address - Street 1:10 N MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1941
Practice Address - Country:US
Practice Address - Phone:860-748-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical