Provider Demographics
NPI:1477780880
Name:GEORGE, CAILIN MARY (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CAILIN
Middle Name:MARY
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MERCYCARE LN
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-3504
Mailing Address - Country:US
Mailing Address - Phone:518-452-6708
Mailing Address - Fax:518-452-6770
Practice Address - Street 1:3 MERCYCARE LN
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-3504
Practice Address - Country:US
Practice Address - Phone:518-452-6708
Practice Address - Fax:518-452-6770
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000655-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health