Provider Demographics
NPI:1326007634
Name:WALDRIP, KAITLIN M (LCSW C)
Entity Type:Individual
Prefix:MS
First Name:KAITLIN
Middle Name:M
Last Name:WALDRIP
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 660
Mailing Address - Street 2:301 RANDOLPH ST
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629
Mailing Address - Country:US
Mailing Address - Phone:410-479-4306
Mailing Address - Fax:410-479-1714
Practice Address - Street 1:1013 TALBOT ST
Practice Address - Street 2:UNIT L
Practice Address - City:ST MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663
Practice Address - Country:US
Practice Address - Phone:410-745-5020
Practice Address - Fax:410-745-0492
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD06847104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker