Provider Demographics
NPI:1437527488
Name:CALDWELL, MEGHAN (LICSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:CALDWELL
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 1:125 NASHUA ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 NASHUA ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1100
Practice Address - Country:US
Practice Address - Phone:857-272-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
MA1224561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1004745OtherNHP
MA99618201OtherNETWORK HEALTH
MA042611055OtherTAX ID
MA122456OtherNASW
MA1303287Medicaid
MAM18633OtherBCBS
MA0000023532OtherBMC
MA1303287OtherMBHP