Provider Demographics
NPI:1437969276
Name:GRIEBEL, CAITLYN JANE
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:JANE
Last Name:GRIEBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BROAD ST # 213
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4335
Mailing Address - Country:US
Mailing Address - Phone:337-429-5105
Mailing Address - Fax:337-888-9853
Practice Address - Street 1:500 BROAD ST # 213
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4335
Practice Address - Country:US
Practice Address - Phone:337-429-5105
Practice Address - Fax:337-888-9853
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator