Provider Demographics
NPI:1821247487
Name:DOOLITTLE, NICHOLAS CLARK (LICSW)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:CLARK
Last Name:DOOLITTLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BRIGHAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-9576
Mailing Address - Country:US
Mailing Address - Phone:617-864-8423
Mailing Address - Fax:
Practice Address - Street 1:101 BRIGHAM HILL RD
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9576
Practice Address - Country:US
Practice Address - Phone:617-864-8423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical