Provider Demographics
NPI:1215321872
Name:MASIELLO, EVE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:EVE
Middle Name:
Last Name:MASIELLO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:EVE
Other - Middle Name:
Other - Last Name:MASIELLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:9 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-3237
Mailing Address - Country:US
Mailing Address - Phone:781-710-7356
Mailing Address - Fax:508-732-8701
Practice Address - Street 1:9 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-3237
Practice Address - Country:US
Practice Address - Phone:781-710-7356
Practice Address - Fax:508-732-8701
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-22
Last Update Date:2015-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10153461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical