MEDICARE: CAITLIN LESLIE SHIFLETT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904012849	VA

General Provider Information

NPI Number	:	1639835325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN LESLIE SHIFLETT LCSW

Provider Business Mailing Address
First Line	:	1908 NEWMAN RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-1616
Country	:	US
Telephone Number	:	540-550-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N ARTHUR ASHE BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4304
Country	:	US
Telephone Number	:	540-550-6787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2021
Last Update Date	:	11/17/2021

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