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General NPI Number Information
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NPI Number | 1144018904
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Entity Type | Individual
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Provider Name | MICHAEL ROBERTS KITZ LCSW, SAC
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Gender | Male
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 57 ORCHARD ST
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City | MARLBOROUGH
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State | MA
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Zip | 01752-4326
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Country | US
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Telephone | 508-481-3611
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Fax | 508-460-0493
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Provider Business Mailing Address
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Address Line | 33 OAK ST APT 2
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City | CLINTON
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State | MA
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Zip | 01510-3706
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Country | US
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Telephone | 603-313-2308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW225677
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License Number State | MA
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