Provider Demographics
NPI:1316269350
Name:DELFS, CAITLIN HERZINGER (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:HERZINGER
Last Name:DELFS
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 POWERS FERRY RD SE STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-9489
Mailing Address - Country:US
Mailing Address - Phone:770-565-3045
Mailing Address - Fax:
Practice Address - Street 1:1642 POWERS FERRY RD SE STE 100
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-9489
Practice Address - Country:US
Practice Address - Phone:770-565-3045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1084375103K00000X
GAPSY003346103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA840297646BMedicaid