Provider Demographics
NPI:1962973719
Name:TRIPPI-LEROUX, SANDRA (LICSW)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:TRIPPI-LEROUX
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 GRANITE STREET LEOMINSTER HIGH SCHOOL
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-534-7715
Mailing Address - Fax:978-537-1765
Practice Address - Street 1:122 GRANITE STREET LEOMINSTER HIGH SCHOOL
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-534-7715
Practice Address - Fax:978-537-1765
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10273651041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool