Provider Demographics
NPI:1710264148
Name:ANDREWS, CAITLIN L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:L
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:L
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1383 DEER MOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-6707
Mailing Address - Country:US
Mailing Address - Phone:907-821-2161
Mailing Address - Fax:888-389-5014
Practice Address - Street 1:1383 DEER MOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-6707
Practice Address - Country:US
Practice Address - Phone:907-821-2161
Practice Address - Fax:888-389-5014
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X
AK13781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker