Provider Demographics
NPI:1629455746
Name:SUTHER, CAITLIN HERMAN (LPCA)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:HERMAN
Last Name:SUTHER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 N NC HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:CHINA GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28023-7587
Mailing Address - Country:US
Mailing Address - Phone:704-453-1307
Mailing Address - Fax:
Practice Address - Street 1:2655 N NC HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-7587
Practice Address - Country:US
Practice Address - Phone:704-453-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional