MEDICARE: CATHERINE CAUDILL 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	37903	ID
2	1041C0700X	Clinical Social Worker	0904010644	VA

General Provider Information

NPI Number	:	1942742838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE CAUDILL LCSW

Provider Business Mailing Address
First Line	:	6208 FITZHUGH AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2813
Country	:	US
Telephone Number	:	276-608-1152
Fax Number	:

Provider Business Practice Location Address
First Line	:	6208 FITZHUGH AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2813
Country	:	US
Telephone Number	:	276-608-1152
Fax Number	:

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

Provider Enumeration Date	:	11/09/2016
Last Update Date	:	08/30/2018

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Directions to “ CATHERINE CAUDILL LCSW” Practice Location

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