Provider Demographics
NPI:1871981175
Name:MCCADDIN, EDITH (MSW, LICSW, LCSW)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:MCCADDIN
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 RIVERSIDE FARM DR
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:NH
Mailing Address - Zip Code:03861-6216
Mailing Address - Country:US
Mailing Address - Phone:603-978-7650
Mailing Address - Fax:
Practice Address - Street 1:278 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5455
Practice Address - Country:US
Practice Address - Phone:603-978-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3731041C0700X
MELC115291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical