Provider Demographics
NPI:1306210828
Name:BENEDICT, CAITLYN ELIZABETH (LSW)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ELIZABETH
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6756 WINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-7119
Mailing Address - Country:US
Mailing Address - Phone:304-412-1692
Mailing Address - Fax:
Practice Address - Street 1:6756 WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-7119
Practice Address - Country:US
Practice Address - Phone:304-412-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP00944187104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker