Provider Demographics
NPI:1144413816
Name:CALDWELL, BARBARA P
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:P
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 LANG AVE NE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4474
Mailing Address - Country:US
Mailing Address - Phone:505-798-2541
Mailing Address - Fax:505-796-9601
Practice Address - Street 1:4801 LANG AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4474
Practice Address - Country:US
Practice Address - Phone:505-798-2541
Practice Address - Fax:505-796-9601
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0086331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM55753566Medicaid