Provider Demographics
NPI:1053038786
Name:SMITH, CAIDIN THOMAS (LCSW, LMSW)
Entity type:Individual
Prefix:
First Name:CAIDIN
Middle Name:THOMAS
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6586 ATLANTIC AVE # 136
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1617
Mailing Address - Country:US
Mailing Address - Phone:203-240-0426
Mailing Address - Fax:
Practice Address - Street 1:6586 ATLANTIC AVE # 136
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1617
Practice Address - Country:US
Practice Address - Phone:203-240-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLSW233151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty