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General NPI Number Information
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NPI Number | 1659566495
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Entity Type | Individual
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Provider Name | SHIRLEY SUE CAYKO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 1601 2ND AVE N STE 400
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City | GREAT FALLS
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State | MT
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Zip | 59401-3276
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Country | US
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Telephone | 406-453-0088
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 373
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City | ULM
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State | MT
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Zip | 59485-0373
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Country | US
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Telephone | 406-268-1069
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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 | 803 LCSW
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License Number State | MT
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