Provider Demographics
NPI:1700404209
Name:DITUCCI, ALEXANDRA NICOLE (MSS, LICSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:DITUCCI
Suffix:
Gender:F
Credentials:MSS, LICSW
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:DITUCCI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSS, LICSW
Mailing Address - Street 1:125 WESTGATE CENTER DR # 1056
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9588
Mailing Address - Country:US
Mailing Address - Phone:413-341-4606
Mailing Address - Fax:
Practice Address - Street 1:17 BREWSTER CT
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3801
Practice Address - Country:US
Practice Address - Phone:413-341-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1267091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical