Provider Demographics
NPI:1104717065
Name:RIZZO, KRISTEN (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:RIZZO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FOLLY POND RD APT 32
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5385
Mailing Address - Country:US
Mailing Address - Phone:516-902-5184
Mailing Address - Fax:
Practice Address - Street 1:285 COMMANDANTS WAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-4057
Practice Address - Country:US
Practice Address - Phone:617-241-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2287501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical