Provider Demographics
NPI:1942742838
Name:CAUDILL, CATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CAUDILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 FITZHUGH AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2813
Mailing Address - Country:US
Mailing Address - Phone:276-608-1152
Mailing Address - Fax:
Practice Address - Street 1:6208 FITZHUGH AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2813
Practice Address - Country:US
Practice Address - Phone:276-608-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID379031041C0700X
VA09040106441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical