Provider Demographics
NPI:1063281350
Name:SANCHEZ, CAITLYN NICOLE (MHC-LP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:NICOLE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S FRANKLIN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6105
Mailing Address - Country:US
Mailing Address - Phone:484-341-3390
Mailing Address - Fax:
Practice Address - Street 1:108 S FRANKLIN AVE STE 3
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6105
Practice Address - Country:US
Practice Address - Phone:516-303-9925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP126395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health