Healthcare Provider Details

I. General information

NPI: 1134778541
Provider Name (Legal Business Name): AUSTIN ALBERT LOCHAN DODD MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AUSTIN ALBERT DODD BA

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 WEST ST
MILFORD MA
01757-2236
US

IV. Provider business mailing address

PO BOX 1165
WORCESTER MA
01613-1165
US

V. Phone/Fax

Practice location:
  • Phone: 508-634-3420
  • Fax:
Mailing address:
  • Phone: 774-314-2320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1143338
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number226931
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: