Provider Demographics
NPI:1578939211
Name:BUTTIGIEG, CAITLYN (LICSW)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:BUTTIGIEG
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 1:3 BOULEVARD ST STE 1R
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-5400
Mailing Address - Country:US
Mailing Address - Phone:781-570-3530
Mailing Address - Fax:
Practice Address - Street 1:3 BOULEVARD ST STE 1R
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-5400
Practice Address - Country:US
Practice Address - Phone:781-570-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 1041C0700X, 222Q00000X
MA1258211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist