Provider Demographics
NPI:1942787395
Name:MISENHEIMER, CAITLIN N (LMSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:N
Last Name:MISENHEIMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24008
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-4008
Mailing Address - Country:US
Mailing Address - Phone:501-223-9948
Mailing Address - Fax:501-223-2941
Practice Address - Street 1:3300 S MARKET ST STE 118
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8127
Practice Address - Country:US
Practice Address - Phone:479-366-0850
Practice Address - Fax:501-223-2941
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8937-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker