Provider Demographics
NPI:1104137850
Name:CIOTTI, LORI GROSSMAN (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:GROSSMAN
Last Name:CIOTTI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:GROSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2402
Mailing Address - Country:US
Mailing Address - Phone:617-290-4424
Mailing Address - Fax:
Practice Address - Street 1:28 OAK ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2402
Practice Address - Country:US
Practice Address - Phone:617-290-4424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1168931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical