Healthcare Provider Details

I. General information

NPI: 1588573091
Provider Name (Legal Business Name): KERRIN SILCOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BLACKBURN CTR
GLOUCESTER MA
01930-2268
US

IV. Provider business mailing address

360 MASSACHUSETTS AVENUE, SUITE 103, ACTON, MA 01720
ACTON MA
01720
US

V. Phone/Fax

Practice location:
  • Phone: 978-264-3500
  • Fax:
Mailing address:
  • Phone: 978-264-3553
  • Fax: 978-263-3498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: