Provider Demographics
NPI:1306622097
Name:ANDERS, CAITLYN (LMSW)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:ANDERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:BLAKELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4423 NORWAY DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-3123
Mailing Address - Country:US
Mailing Address - Phone:318-499-1655
Mailing Address - Fax:
Practice Address - Street 1:670 ALBEMARLE DR BLDG 7
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-5945
Practice Address - Country:US
Practice Address - Phone:318-562-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18101104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker