Provider Demographics
NPI:1730269903
Name:DIFILIPPO, ANDREA CELESTE (LICSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CELESTE
Last Name:DIFILIPPO
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 1:82 COUNTY RD PMB #1
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1651
Mailing Address - Country:US
Mailing Address - Phone:508-965-9657
Mailing Address - Fax:508-992-7455
Practice Address - Street 1:345 FRONT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1537
Practice Address - Country:US
Practice Address - Phone:508-965-9657
Practice Address - Fax:508-748-0193
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1080491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical