Provider Demographics
NPI:1376057851
Name:FLAUM, CAITLIN (LPC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:FLAUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:MANCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1680 IRON SPRINGS ROAD
Mailing Address - Street 2:STE. 103
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305
Mailing Address - Country:US
Mailing Address - Phone:928-458-3327
Mailing Address - Fax:
Practice Address - Street 1:1678 OAKLAWN DR STE A
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1109
Practice Address - Country:US
Practice Address - Phone:928-458-3327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-16986101YM0800X
AZLPC-18965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health