Provider Demographics
NPI:1073086112
Name:DUCHIN, CAROLINE ABIGAIL (LICSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ABIGAIL
Last Name:DUCHIN
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 1:201 S HUNTINGTON AVE UNIT 712
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-5274
Mailing Address - Country:US
Mailing Address - Phone:339-213-4192
Mailing Address - Fax:
Practice Address - Street 1:201 S HUNTINGTON AVE UNIT 712
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-5274
Practice Address - Country:US
Practice Address - Phone:339-213-4192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2238231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical