Provider Demographics
NPI:1689921900
Name:VANSLOOTEN, CAITLIN (LICSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:VANSLOOTEN
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 1:32 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1705
Mailing Address - Country:US
Mailing Address - Phone:617-785-9128
Mailing Address - Fax:
Practice Address - Street 1:32 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1705
Practice Address - Country:US
Practice Address - Phone:617-785-9128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1181171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303287OtherMBHP
MA1004745OtherNHP
MA0000023532OtherBMC
MA1303287Medicaid
MA99618201OtherNETWORK HEALTH
MAM18633OtherBCBS
MA0000023532OtherBMC