Provider Demographics
NPI:1184225567
Name:FRAGGETTA, DOROTHY A (LICSW)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:A
Last Name:FRAGGETTA
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CTR STE 432A
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6122
Mailing Address - Country:US
Mailing Address - Phone:978-712-8126
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 432A
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6122
Practice Address - Country:US
Practice Address - Phone:978-712-8126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1264441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical