Provider Demographics
NPI:1033956784
Name:BOEDING, CAITLYN GUITRAU (LMSW)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:GUITRAU
Last Name:BOEDING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:GUITRAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1058 E WORTHY ST
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4359
Mailing Address - Country:US
Mailing Address - Phone:225-258-7322
Mailing Address - Fax:
Practice Address - Street 1:38058 LA-621
Practice Address - Street 2:UNIT B
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-402-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16988104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker