Provider Demographics
NPI:1477237162
Name:CAUDILL, CALLIE NICOLE (LCSWA)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:NICOLE
Last Name:CAUDILL
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 1:537 COLLEGE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2412
Mailing Address - Country:US
Mailing Address - Phone:828-407-0243
Mailing Address - Fax:
Practice Address - Street 1:537 COLLEGE ST STE 102
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2412
Practice Address - Country:US
Practice Address - Phone:828-407-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0188421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical