Provider Demographics
NPI:1386682151
Name:DANIELS-DOOLIN, AMY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:DANIELS-DOOLIN
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 1:57 CHAMBERLAIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2004
Mailing Address - Country:US
Mailing Address - Phone:978-692-9855
Mailing Address - Fax:
Practice Address - Street 1:6 COURTHOUSE LANE
Practice Address - Street 2:UNIT 9 DOOR B
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824
Practice Address - Country:US
Practice Address - Phone:978-835-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110654104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker