Provider Demographics
NPI:1164039954
Name:FELKINS, CAITLIN (BCBA)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:FELKINS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 VALLEY HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8705
Mailing Address - Country:US
Mailing Address - Phone:318-372-6386
Mailing Address - Fax:
Practice Address - Street 1:1300 HUDSON LN STE 9
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6054
Practice Address - Country:US
Practice Address - Phone:318-953-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-479103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst