Basic Information
| Provider Information | |||||||||
| NPI: | 1104569508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLAUGHLIN | ||||||||
| FirstName: | CAITLIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 752 W OAKRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | FERNDALE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482202740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484599363 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6900 E 10 MILE RD | ||||||||
| Address2: | |||||||||
| City: | CENTER LINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480151168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865013070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2022 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 096114 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.