Provider Demographics
NPI:1881456317
Name:SANTOPIETRO, ALISSA
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:SANTOPIETRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 HILL RD
Mailing Address - Street 2:
Mailing Address - City:TERRYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06786-4008
Mailing Address - Country:US
Mailing Address - Phone:203-217-8331
Mailing Address - Fax:
Practice Address - Street 1:15 WOODSIDE CIR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-1528
Practice Address - Country:US
Practice Address - Phone:203-937-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7651104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker