Provider Demographics
NPI:1861010985
Name:LENNON, CAITLIN (LICSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:LENNON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 HANOVER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1312
Mailing Address - Country:US
Mailing Address - Phone:603-863-1951
Mailing Address - Fax:
Practice Address - Street 1:71 BELKNAP AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1536
Practice Address - Country:US
Practice Address - Phone:603-863-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077550Medicaid