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General NPI Number Information
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NPI Number | 1114607033
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Entity Type | Individual
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Provider Name | YARITZA CAICEDO LMSW, CASAC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 99 CAMERON ST
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City | PINE BUSH
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State | NY
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Zip | 12566-7113
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Country | US
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Telephone | 845-563-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 ROUTE 9W STE 10
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City | CORNWALL
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State | NY
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Zip | 12518-1370
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Country | US
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Telephone | 845-220-3100
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Fax | 845-534-2940
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21686
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 107510
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License Number State | NY
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