Provider Demographics
NPI:1992855290
Name:DEFILLIPO, ROXANE MARY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROXANE
Middle Name:MARY
Last Name:DEFILLIPO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 RICHMOND RD
Mailing Address - Street 2:APT. 3I
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2417
Mailing Address - Country:US
Mailing Address - Phone:718-670-3237
Mailing Address - Fax:
Practice Address - Street 1:1492 RICHMOND RD
Practice Address - Street 2:SUITE 3
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2319
Practice Address - Country:US
Practice Address - Phone:718-668-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical