Provider Demographics
NPI:1134363062
Name:HAGGARD, CAILEN M (LISW-S, MSW)
Entity type:Individual
Prefix:MRS
First Name:CAILEN
Middle Name:M
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:LISW-S, MSW
Other - Prefix:
Other - First Name:CAILEN
Other - Middle Name:
Other - Last Name:MAIZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:20525 CENTER RIDGE RD
Mailing Address - Street 2:STE 403
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3401
Mailing Address - Country:US
Mailing Address - Phone:866-466-9591
Mailing Address - Fax:
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:STE 365
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:866-466-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08003521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical