Provider Demographics
NPI:1386282663
Name:SAUCIER, KAITLYN (LADC-II, LICSW)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:SAUCIER
Suffix:
Gender:F
Credentials:LADC-II, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115R S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02779-2026
Mailing Address - Country:US
Mailing Address - Phone:774-231-8008
Mailing Address - Fax:
Practice Address - Street 1:115R S MAIN ST
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MA
Practice Address - Zip Code:02779-2026
Practice Address - Country:US
Practice Address - Phone:774-955-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
23172101YA0400X
1268581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)