Provider Demographics
NPI:1619777406
Name:TREADWAY, CAITLYN (PSYD, LCP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:PSYD, LCP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:LAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5432 STONEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-7014
Mailing Address - Country:US
Mailing Address - Phone:703-231-0469
Mailing Address - Fax:
Practice Address - Street 1:420 N CENTER DR STE 239B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-0014
Practice Address - Country:US
Practice Address - Phone:757-282-6309
Practice Address - Fax:757-271-3979
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008848103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical