Provider Demographics
NPI:1528332145
Name:WELCH, CAILIN BETH (MHC)
Entity type:Individual
Prefix:
First Name:CAILIN
Middle Name:BETH
Last Name:WELCH
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 VANESSA LN
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-5324
Mailing Address - Country:US
Mailing Address - Phone:413-329-0270
Mailing Address - Fax:
Practice Address - Street 1:205 SOUTH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4818
Practice Address - Country:US
Practice Address - Phone:845-554-1365
Practice Address - Fax:845-554-1376
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP77214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health