Provider Demographics
NPI:1245711696
Name:VERDERICO, ROSEMARIE GRACE (MSW)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:GRACE
Last Name:VERDERICO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:GRACE
Other - Last Name:SACCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:39 PEARSON ST
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-2307
Mailing Address - Country:US
Mailing Address - Phone:781-307-2900
Mailing Address - Fax:
Practice Address - Street 1:39 PEARSON ST
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-2307
Practice Address - Country:US
Practice Address - Phone:781-307-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1001621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty