Healthcare Provider Details

I. General information

NPI: 1225637069
Provider Name (Legal Business Name): CAILEY ERIN CLARKE LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2020
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 DESOTO TRL
SYLVA NC
28779-6308
US

IV. Provider business mailing address

60 LIVINGSTON ST STE 100
ASHEVILLE NC
28801-4400
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-8958
  • Fax: 828-586-0649
Mailing address:
  • Phone: 828-707-4473
  • Fax: 828-236-9825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP015318
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierP015318
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: