Healthcare Provider Details

I. General information

NPI: 1457894230
Provider Name (Legal Business Name): CAITLIN YIP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INDEPENDENCE DR
HYANNIS MA
02601-1898
US

IV. Provider business mailing address

PO BOX 760
BREWSTER MA
02631-0760
US

V. Phone/Fax

Practice location:
  • Phone: 347-484-4517
  • Fax:
Mailing address:
  • Phone: 347-484-4517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: