Provider Demographics
NPI:1447071097
Name:DEFILIPPO, JULIE MARIE BOLDUC (PHD, MSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE BOLDUC
Last Name:DEFILIPPO
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 MASSACHUSETTS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4018
Mailing Address - Country:US
Mailing Address - Phone:774-244-3997
Mailing Address - Fax:
Practice Address - Street 1:363 MASSACHUSETTS AVE STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4018
Practice Address - Country:US
Practice Address - Phone:774-244-3997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2237191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical