MEDICARE: CAITLIN SHIRLEY

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	171M00000X	Case Manager/Care Coordinator
2	101YM0800X	Mental Health Counselor	LPC016559	GA

General Provider Information

NPI Number	:	1902226137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN SHIRLEY

Provider Business Mailing Address
First Line	:	87 AMANDA TRCE
Second Line	:
City	:	KINGSLAND
State	:	GA
Zip	:	31548-7821
Country	:	US
Telephone Number	:	859-912-5066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 MADISON RD
Second Line	:
City	:	WALNUT HILLS
State	:	OH
Zip	:	45206-1706
Country	:	US
Telephone Number	:	513-354-5224
Fax Number	:	513-354-5334

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

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	06/18/2026

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Directions to “ CAITLIN SHIRLEY ” Practice Location

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