Healthcare Provider Details

I. General information

NPI: 1972184570
Provider Name (Legal Business Name): CAILEE PRIDDY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7260 N DIXIE HWY
RADCLIFF KY
40160-4900
US

IV. Provider business mailing address

1261 WELDON RD
BRANDENBURG KY
40108-9520
US

V. Phone/Fax

Practice location:
  • Phone: 270-982-9495
  • Fax:
Mailing address:
  • Phone: 270-980-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW00001735
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: