Provider Demographics
NPI:1306392782
Name:ADAMS, CAITLIN A
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 NEW SWEDEN RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06281-3215
Mailing Address - Country:US
Mailing Address - Phone:860-208-5048
Mailing Address - Fax:
Practice Address - Street 1:283 ROUTE 169
Practice Address - Street 2:
Practice Address - City:SOUTH WOODSTOCK
Practice Address - State:CT
Practice Address - Zip Code:06267-6700
Practice Address - Country:US
Practice Address - Phone:860-481-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1198541041C0700X
CT91801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical