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General NPI Number Information
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NPI Number | 1407502495
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Entity Type | Individual
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Provider Name | CAITLIN ELIZABETH DUBLE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 4229 LAFAYETTE CENTER DR STE 1675
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City | CHANTILLY
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State | VA
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Zip | 20151-1270
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Country | US
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Telephone | 855-326-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 711 SKYVIEW DR
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City | CHILHOWIE
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State | VA
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Zip | 24319-4523
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Country | US
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Telephone | 276-698-5592
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904013711
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License Number State | VA
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