Nicole R Distefano
Social Worker, Clinical in Marblehead, Massachusetts
1194556985- Practice location
- 15 Hines CT Unit 19, Marblehead, MA 01945-2582
- Phone
- 781-307-7845
- Fax
- —
- Last updated
- July 24, 2025
Nicole Rose Distefano is a Social Worker, Clinical based in Marblehead, MA. Nicole Rose Distefano practices in Marblehead, MA. The NPI Number for Nicole Rose Distefano is 1194556985 and holds a License No. 127642 (MA). The current practice location address for Nicole Rose Distefano is 15 Hines CT Unit 19, Marblehead, MA 01945-2582 and can be reached out via phone at 781-307-7845.
Provider Profile Details
- NPI Number
- 1194556985
- Provider Name
- Nicole Rose Distefano
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 15 Hines CT Unit 19, Marblehead, MA 01945-2582
- Phone Number
- 781-307-7845
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- August 12, 2024
- Last Update Date
- July 24, 2025
- Certification Date
- July 24, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 15 Hines CT Unit 19
Marblehead, MA 01945-2582 - City
- Marblehead
- State
- Massachusetts
- Zip
- 01945-2582
- Phone Number
- 781-307-7845
Provider Business Mailing Address Details
- Address
- 15 Hines CT Unit 19
Marblehead, MA 01945-2582 - City
- Marblehead
- State
- MA
- Zip
- 01945-2582
- Phone Number
- 781-307-7845
License Information
- License Number
- 127642
- License State
- MA
- Taxonomy
- Social Worker, Clinical · 1041C0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Social Worker, Clinical providers near Marblehead, MA
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- Ann J SmithSocial Worker, Clinical · NPI 1457835720
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- Carol R Johnson, LICSWSocial Worker, Clinical · NPI 1326522947
- Deirdre K Samuelsson, LICSWSocial Worker, Clinical · NPI 1821476938
Frequently Asked Questions
What is the NPI number of Nicole R Distefano?
The NPI number of Nicole R Distefano is 1194556985. It was assigned on August 12, 2024 and is currently active in the NPPES registry.
What is the specialty of Nicole R Distefano?
Nicole R Distefano is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in MA under license number 127642.
Where does Nicole R Distefano practice?
The practice location is 15 Hines CT Unit 19, Marblehead, MA 01945-2582. The office can be reached at 781-307-7845 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1194556985 directly on the NPPES registry website.