Basic Information
| Provider Information | |||||||||
| NPI: | 1689917197 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASWELL | ||||||||
| FirstName: | CATHLEEN | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | CADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27551 S MASLOW RD | ||||||||
| Address2: | |||||||||
| City: | CANBY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970139350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5039613944 | ||||||||
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| Practice Location | |||||||||
| Address1: | 511 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | OREGON CITY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036551029 | ||||||||
| FaxNumber: | 5036554705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2013 | ||||||||
| LastUpdateDate: | 04/03/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 120908 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.