Provider Demographics
NPI:1205578614
Name:BLACKBURN, CAITLIN (LMSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:ZITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7001 MAPLE TREE LN
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1676
Mailing Address - Country:US
Mailing Address - Phone:860-912-7251
Mailing Address - Fax:
Practice Address - Street 1:314 FLANDERS RD STE 2D
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1727
Practice Address - Country:US
Practice Address - Phone:860-629-0029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health