Provider Demographics
NPI:1184090953
Name:BROWN, CAITLYN (LISW-S)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 BILLINGSLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5978
Mailing Address - Country:US
Mailing Address - Phone:614-300-0308
Mailing Address - Fax:614-602-6840
Practice Address - Street 1:2710 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5978
Practice Address - Country:US
Practice Address - Phone:614-300-0308
Practice Address - Fax:614-602-6840
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17004221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid