Provider Demographics
NPI:1811377682
Name:SMITH, CAITLIN ALEXANDRA
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:ALEXANDRA
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MAIN ST
Mailing Address - Street 2:APT. 8
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3715
Mailing Address - Country:US
Mailing Address - Phone:484-941-1231
Mailing Address - Fax:
Practice Address - Street 1:47 MAIN ST
Practice Address - Street 2:8
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3715
Practice Address - Country:US
Practice Address - Phone:484-941-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health