Adesholla Leann Gionet, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Orange, MA

NPI 1093065690 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1093065690
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
120680 (MA)
Practice address
131 W Main St
Orange, MA 01364-1150
Phone
(413) 372-9844
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
220675MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 220675 MA
Clinical Social Worker 1041C0700X 120680 MA Yes

Addresses

Primary practice location

131 W Main St
Orange, MA 01364-1150

Mailing address

4 Muskett Drive
Templeton, MA 01468-1569
Phone (978) 939-8383

Other practice location 1

418 Patriots Road
Templeton, MA 01468-1569
Phone (978) 310-1995

Other providers in Orange, MA

All providers in Orange, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.