Provider Demographics
NPI:1013185073
Name:CALDWELL, ROBERT LEE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13295 ILLINOIS ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3019
Mailing Address - Country:US
Mailing Address - Phone:317-440-4176
Mailing Address - Fax:775-288-3479
Practice Address - Street 1:13295 ILLINOIS ST
Practice Address - Street 2:SUITE 311
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3019
Practice Address - Country:US
Practice Address - Phone:317-440-4176
Practice Address - Fax:775-288-3479
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001353A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN35001353AOtherLMFT