Provider Demographics
NPI:1225637069
Name:CLARKE, CAILEY ERIN (LCSWA)
Entity Type:Individual
Prefix:
First Name:CAILEY
Middle Name:ERIN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LIVINGSTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4400
Mailing Address - Country:US
Mailing Address - Phone:828-707-4473
Mailing Address - Fax:828-236-9825
Practice Address - Street 1:151 DESOTO TRL
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-6308
Practice Address - Country:US
Practice Address - Phone:828-586-8958
Practice Address - Fax:828-586-0649
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0153181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP015318OtherLICENSE