Healthcare Provider Details

I. General information

NPI: 1144014713
Provider Name (Legal Business Name): ADAM SETH KROLOFF LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MASSACHUSETTS AVE UNITS 84 & 85
CAMBRIDGE MA
02139-3067
US

IV. Provider business mailing address

875 MASSACHUSETTS AVE UNITS 84 & 85
CAMBRIDGE MA
02139-3067
US

V. Phone/Fax

Practice location:
  • Phone: 617-354-4450
  • Fax: 833-941-3910
Mailing address:
  • Phone: 617-354-4450
  • Fax: 833-941-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW04419
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00946324
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1143664
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: