Provider Demographics
NPI:1114250784
Name:CALDWELL, LINDA M (LPC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:LYNN
Other - Middle Name:MAE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3939 WEST RIDGE COMMONS SUITE B-41
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506
Mailing Address - Country:US
Mailing Address - Phone:814-838-1400
Mailing Address - Fax:814-838-7743
Practice Address - Street 1:3939 WEST RIDGE COMMONS SUITE B-41
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:814-838-1400
Practice Address - Fax:814-838-7743
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC005185Medicaid