Provider Demographics
NPI:1639946304
Name:LAURIE DEGRAPPO LICSW LLC
Entity Type:Organization
Organization Name:LAURIE DEGRAPPO LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGRAPPO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:267-879-1789
Mailing Address - Street 1:2 CENTRAL ST STE 13
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-1940
Mailing Address - Country:US
Mailing Address - Phone:267-879-1789
Mailing Address - Fax:
Practice Address - Street 1:2 CENTRAL ST STE 13
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1940
Practice Address - Country:US
Practice Address - Phone:267-879-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty