Provider Demographics
NPI:1336578061
Name:TIRONE, NICOLE J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:J
Last Name:TIRONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:J
Other - Last Name:TIRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 BRIDGE ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1270
Mailing Address - Country:US
Mailing Address - Phone:978-459-2306
Mailing Address - Fax:978-453-9394
Practice Address - Street 1:81 BRIDGE ST
Practice Address - Street 2:SUITE 215
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1270
Practice Address - Country:US
Practice Address - Phone:978-459-2306
Practice Address - Fax:978-453-9394
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 1041C0700X
MA2221661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker