Provider Demographics
NPI:1609950294
Name:TRIFFLETTI, NOEL E (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:NOEL
Middle Name:E
Last Name:TRIFFLETTI
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 1:124 LONG POND RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2664
Mailing Address - Country:US
Mailing Address - Phone:774-773-9956
Mailing Address - Fax:774-773-9958
Practice Address - Street 1:124 LONG POND RD
Practice Address - Street 2:14
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2664
Practice Address - Country:US
Practice Address - Phone:774-773-9956
Practice Address - Fax:774-773-9958
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10221351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MATR-6515Medicare ID - Type Unspecified