| Doctor Name: | MR. LOREN RAYMOND CAUDLE |
| NPI Number: | 1972943090 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MAC |
| License Number: | CL60200343 |
| Business Practice Address: | 111 Main Street Sutie 140 Lewiston, ID - 83501 |
| Business Phone Number: | 2087463040 |
| Business Fax Number: | 2087463603 |
| Mailing Address: | 111 Main Street, Sutie 140 LEWISTON |
| State: | ID |
| Postal Code: | 83501 |
| Phone Number: | 2087463040 |
| Fax Number: | 2087463603 |
| NPI Enumeration Date: | 07/03/2013 |
| NPI Last Update Date: | 07/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | CL60200343 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |