Provider Demographics
NPI:1144018904
Name:KITZ, MICHAEL ROBERTS (LCSW, SAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROBERTS
Last Name:KITZ
Suffix:
Gender:M
Credentials:LCSW, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OAK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-3706
Mailing Address - Country:US
Mailing Address - Phone:603-313-2308
Mailing Address - Fax:
Practice Address - Street 1:57 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4326
Practice Address - Country:US
Practice Address - Phone:508-481-3611
Practice Address - Fax:508-460-0493
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2256771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical