Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Evelyn Dougherty, LICSW

Individual provider Clinical Social Worker · NPI 1861539629

Evelyn Dougherty, LICSW is a Clinical Social Worker in Jamaica Plain, Massachusetts. Qualified in 1981, 45 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
45
Licensed in
MA
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

11 Green St
Jamaica Plain, MA 02130-2588
Phone: (617) 862-8732
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 107476 (MA)

Record details

NPI number1861539629
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJanuary 31, 2007
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024
Mailing addressPo Box 300415, Jamaica Plain, MA 02130-0004

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1981 (45 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Jamaica Plain