Provider Demographics
NPI:1932300936
Name:GILLETT, DARWIN (MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:DARWIN
Middle Name:
Last Name:GILLETT
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERRIMAC ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2558
Mailing Address - Country:US
Mailing Address - Phone:978-270-0394
Mailing Address - Fax:
Practice Address - Street 1:1 MERRIMAC ST
Practice Address - Street 2:SUITE 16
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2558
Practice Address - Country:US
Practice Address - Phone:978-270-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1115041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP08578OtherBLUE CROSS-BLUE SHIELD
MAQ54000Medicare UPIN
MAP08578OtherBLUE CROSS-BLUE SHIELD