Provider Demographics
NPI:1699252320
Name:TOLFA, PETER EDWARD I (LICSW)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:EDWARD
Last Name:TOLFA
Suffix:I
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HIGHLAND MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6509
Mailing Address - Country:US
Mailing Address - Phone:401-651-6406
Mailing Address - Fax:
Practice Address - Street 1:82 HIGHLAND MEADOW DR
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6509
Practice Address - Country:US
Practice Address - Phone:401-651-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1005671041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool