Healthcare Provider Details

I. General information

NPI: 1487951448
Provider Name (Legal Business Name): MELVIN CAUTHEN MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2011
Last Update Date: 02/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

1423 TAYLOR ST NW
WASHINGTON DC
20011-5509
US

V. Phone/Fax

Practice location:
  • Phone: 202-368-6730
  • Fax:
Mailing address:
  • Phone: 202-368-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLG50078815
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: