Healthcare Provider Details

I. General information

NPI: 1134092224
Provider Name (Legal Business Name): INGRID CAUTHORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 MAPLEWOOD AVE
RICHMOND VA
23221-3507
US

IV. Provider business mailing address

3021 MAPLEWOOD AVE
RICHMOND VA
23221-3507
US

V. Phone/Fax

Practice location:
  • Phone: 804-780-6252
  • Fax:
Mailing address:
  • Phone: 804-780-6252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: