Provider Demographics
NPI:1477390219
Name:DAVIE, CAITLIN (MHC-LP)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:DAVIE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 EAST AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2321
Mailing Address - Country:US
Mailing Address - Phone:315-944-5201
Mailing Address - Fax:
Practice Address - Street 1:150 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1400
Practice Address - Country:US
Practice Address - Phone:585-602-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-P129466-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health