Provider Demographics
NPI:1225644644
Name:CALDWELL, AMY RULE (BSN, MA, LPC, LAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RULE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:BSN, MA, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3136
Mailing Address - Country:US
Mailing Address - Phone:720-316-5593
Mailing Address - Fax:
Practice Address - Street 1:1807 S PEARL ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3136
Practice Address - Country:US
Practice Address - Phone:720-316-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001410101YA0400X
COLPC.0016519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)