Provider Demographics
NPI:1861840605
Name:OMENSETTER, CAITLYN (MA)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:OMENSETTER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RED HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18076-1361
Mailing Address - Country:US
Mailing Address - Phone:215-593-7861
Mailing Address - Fax:
Practice Address - Street 1:4 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1314
Practice Address - Country:US
Practice Address - Phone:215-757-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health