Healthcare Provider Details

I. General information

NPI: 1457441248
Provider Name (Legal Business Name): LYNNE D CAUTHEN LCSW,PIP,ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNNE E DOVERSPIKE LCSW,PIP,ACSW

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 2ND AVE SE SUITE 4
DECATUR AL
35601-2315
US

IV. Provider business mailing address

113 2ND AVE SE STE 4
DECATUR AL
35601-2315
US

V. Phone/Fax

Practice location:
  • Phone: 256-822-2375
  • Fax:
Mailing address:
  • Phone: 256-822-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0102C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: