Provider Demographics
NPI:1871678573
Name:D'ADDIECO, MARIA VICTORIA (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:VICTORIA
Last Name:D'ADDIECO
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 1:375 MAIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3573
Mailing Address - Country:US
Mailing Address - Phone:617-947-7239
Mailing Address - Fax:
Practice Address - Street 1:375 MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3573
Practice Address - Country:US
Practice Address - Phone:617-947-7239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical