Provider Demographics
NPI:1366934937
Name:GREENBERG, CAITLIN EARLY (LCSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:EARLY
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:JANELLE
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 COMMERCIAL BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5716
Practice Address - Country:US
Practice Address - Phone:415-448-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA752501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical