Provider Demographics
NPI:1164826301
Name:DELGRECO BISSON, CHRISTINE M (LICSW, LADC 1)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:DELGRECO BISSON
Suffix:
Gender:F
Credentials:LICSW, LADC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 COURT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4372
Mailing Address - Country:US
Mailing Address - Phone:774-316-3111
Mailing Address - Fax:
Practice Address - Street 1:310 COURT ST STE 103
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4372
Practice Address - Country:US
Practice Address - Phone:774-316-3111
Practice Address - Fax:774-316-3122
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15622101YA0400X
MA1235351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)