Provider Demographics
NPI:1740905686
Name:CASTELLANI, ALYSSA NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:NICOLE
Last Name:CASTELLANI
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 1:49 SAVIN HILL AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-4106
Mailing Address - Country:US
Mailing Address - Phone:860-309-4583
Mailing Address - Fax:
Practice Address - Street 1:49 SAVIN HILL AVE APT 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02125-4106
Practice Address - Country:US
Practice Address - Phone:860-309-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000227757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker