Provider Demographics
NPI:1356700553
Name:THE CAFFERTY CLINIC
Entity type:Organization
Organization Name:THE CAFFERTY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CATC
Authorized Official - Phone:760-517-6544
Mailing Address - Street 1:543 ENCINITAS BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3744
Mailing Address - Country:US
Mailing Address - Phone:760-517-6544
Mailing Address - Fax:
Practice Address - Street 1:543 ENCINITAS BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3744
Practice Address - Country:US
Practice Address - Phone:760-517-6544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty