Provider Demographics
NPI:1528163946
Name:CAULEY, CATHLEEN (MSW)
Entity type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:
Last Name:CAULEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 UNIVERSITY BLVD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-3228
Mailing Address - Country:US
Mailing Address - Phone:904-421-6053
Mailing Address - Fax:904-744-8131
Practice Address - Street 1:2354 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3228
Practice Address - Country:US
Practice Address - Phone:904-421-6053
Practice Address - Fax:904-744-8131
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767177600Medicaid