Provider Demographics
NPI:1144948472
Name:SHEALY, CAITLIN RENEE (MMFT, LMFT)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:RENEE
Last Name:SHEALY
Suffix:
Gender:F
Credentials:MMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 ADLEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6511
Mailing Address - Country:US
Mailing Address - Phone:864-589-9955
Mailing Address - Fax:
Practice Address - Street 1:230 ADLEY WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6511
Practice Address - Country:US
Practice Address - Phone:864-589-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist