Provider Demographics
NPI:1134528789
Name:BELOWICH, KAITLIN (LICSW)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:BELOWICH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:ALLEY
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:431 RIVER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5483
Mailing Address - Country:US
Mailing Address - Phone:781-891-0555
Mailing Address - Fax:
Practice Address - Street 1:431 RIVER ST STE 2
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5483
Practice Address - Country:US
Practice Address - Phone:781-966-5677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2220471041C0700X
MA1215711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical