Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Rose Distefano

Individual provider Clinical Social Worker · NPI 1194556985

Nicole Rose Distefano is a Clinical Social Worker in Marblehead, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts.

Licensed in
MA
In the registry since
2024

Practice location Address checks out

15 Hines Ct Unit 19
Marblehead, MA 01945-2582
Phone: (781) 307-7845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 127642 (MA)

Record details

NPI number1194556985
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 12, 2024
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025
Mailing address15 Hines Ct Unit 19, Marblehead, MA 01945-2582

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