Provider Demographics
NPI:1861517500
Name:CAULEY, KEISHA TAMIKA (BA)
Entity type:Individual
Prefix:
First Name:KEISHA
Middle Name:TAMIKA
Last Name:CAULEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 N CORLIES ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3008
Mailing Address - Country:US
Mailing Address - Phone:215-568-0860
Mailing Address - Fax:215-825-3701
Practice Address - Street 1:112 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19102-1510
Practice Address - Country:US
Practice Address - Phone:215-568-0860
Practice Address - Fax:215-825-3701
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor