Provider Demographics
NPI:1366597205
Name:CAULFIELD, JOSEPH B (EDD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:CAULFIELD
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-2416
Mailing Address - Country:US
Mailing Address - Phone:218-741-3453
Mailing Address - Fax:
Practice Address - Street 1:314 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2416
Practice Address - Country:US
Practice Address - Phone:218-741-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1478103G00000X, 103TC0700X
MN302260103TS0200X
MN066861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical