Provider Demographics
NPI:1679880157
Name:VICIERE, CELESTE MARIE
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:MARIE
Last Name:VICIERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 OAKCREST RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02136-6355
Mailing Address - Country:US
Mailing Address - Phone:781-786-8648
Mailing Address - Fax:
Practice Address - Street 1:36 OAKCREST RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02136-6355
Practice Address - Country:US
Practice Address - Phone:781-786-8648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health