Provider Demographics
NPI:1144069998
Name:SCOTT, CAITLIN J (LICSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:J
Other - Last Name:DERBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 SELBY AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2855
Mailing Address - Country:US
Mailing Address - Phone:651-571-0549
Mailing Address - Fax:
Practice Address - Street 1:370 SELBY AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2855
Practice Address - Country:US
Practice Address - Phone:651-571-0549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN242661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical