1558899484 NPI number — MS. MARIA ANGELA SCIPPA LICSW

Table of content: MS. MARIA ANGELA SCIPPA LICSW (NPI 1558899484)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558899484 NPI number — MS. MARIA ANGELA SCIPPA LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCIPPA
Provider First Name:
MARIA
Provider Middle Name:
ANGELA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCIPPA
Provider Other First Name:
MARIA
Provider Other Middle Name:
ANGELA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1558899484
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 NORTH AVE STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAKEFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01880-2300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-256-4388
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 NORTH AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAKEFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01880-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
857-256-4388
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 123265 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1558899484 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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