Provider Demographics
NPI:1922390772
Name:WHITE, CAITLIN M (MSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TOTMAN ST.
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2118
Mailing Address - Country:US
Mailing Address - Phone:617-745-0050
Mailing Address - Fax:617-745-0052
Practice Address - Street 1:21 TOTMAN ST.
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-2118
Practice Address - Country:US
Practice Address - Phone:617-745-0050
Practice Address - Fax:617-745-0052
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1196741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical