Provider Demographics
NPI:1649280330
Name:MCCAULEY, REID C (LCSWR)
Entity type:Individual
Prefix:MR
First Name:REID
Middle Name:C
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-3504
Mailing Address - Country:US
Mailing Address - Phone:518-272-6228
Mailing Address - Fax:518-689-0241
Practice Address - Street 1:2 TOWER PLACE
Practice Address - Street 2:EXECUTIVE PARK
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203
Practice Address - Country:US
Practice Address - Phone:518-272-6228
Practice Address - Fax:518-689-0241
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054961-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical