Provider Demographics
NPI:1063025500
Name:KAGLIC, CAITLIN L (LPC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:L
Last Name:KAGLIC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:L
Other - Last Name:LEININGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1805
Mailing Address - Country:US
Mailing Address - Phone:330-455-0374
Mailing Address - Fax:330-453-6716
Practice Address - Street 1:130 1ST ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-5452
Practice Address - Country:US
Practice Address - Phone:330-833-0234
Practice Address - Fax:330-837-7705
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC2103511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health