Provider Demographics
NPI:1568777902
Name:SORIANO, CAITLIN M (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:M
Last Name:SORIANO
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:M
Other - Last Name:SHAFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:405 E HARTSON AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1329
Mailing Address - Country:US
Mailing Address - Phone:509-818-0140
Mailing Address - Fax:509-495-1426
Practice Address - Street 1:405 E HARTSON AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1343
Practice Address - Country:US
Practice Address - Phone:509-624-0268
Practice Address - Fax:509-847-1117
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60043497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2010039Medicaid