Provider Demographics
NPI:1376791939
Name:NOONE, CAITLIN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:
Last Name:NOONE
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 1:360 MARKET ST
Mailing Address - Street 2:APT. 12A
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2743
Mailing Address - Country:US
Mailing Address - Phone:978-621-7696
Mailing Address - Fax:
Practice Address - Street 1:112 MARKET ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1125
Practice Address - Country:US
Practice Address - Phone:781-644-2628
Practice Address - Fax:781-595-4393
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1170171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical