Provider Demographics
NPI:1134951155
Name:KAHL, CAITLIN (LMSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:KAHL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:GRISWOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:63 WONDERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-9433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 NORTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1826
Practice Address - Country:US
Practice Address - Phone:315-412-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124253-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker