Provider Demographics
NPI:1184055790
Name:CACCIATO, CLAUDIA (LMSW)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:CACCIATO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16664 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-3713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1603 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2065
Practice Address - Country:US
Practice Address - Phone:248-514-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2025-05-22
Deactivation Date:2021-04-08
Deactivation Code:
Reactivation Date:2021-04-29
Provider Licenses
StateLicense IDTaxonomies
MI6801091126104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker