Provider Demographics
NPI:1790949907
Name:CETRINO, TAMMY ROCHA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:ROCHA
Last Name:CETRINO
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 1:4 BRIAR PATCH CIR
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1514
Mailing Address - Country:US
Mailing Address - Phone:617-851-9928
Mailing Address - Fax:
Practice Address - Street 1:125 CHURCH ST STE 90-104
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1929
Practice Address - Country:US
Practice Address - Phone:781-754-6545
Practice Address - Fax:781-536-0016
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1163601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical