Provider Demographics
NPI:1659840148
Name:FIRICANO, JUDITH ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:FIRICANO
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 1:14 BRISSETT ST
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4502
Mailing Address - Country:US
Mailing Address - Phone:978-551-0564
Mailing Address - Fax:
Practice Address - Street 1:14 BRISSETT ST
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4502
Practice Address - Country:US
Practice Address - Phone:978-551-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1058841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical