Provider Demographics
NPI:1346409471
Name:LESLEY CALDWELL, MA, LPC
Entity Type:Organization
Organization Name:LESLEY CALDWELL, MA, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL MEDICAL CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-773-1279
Mailing Address - Street 1:4425 S MOPAC EXPY
Mailing Address - Street 2:BUILDING III, SUITE 603
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4425 S MOPAC EXPY
Practice Address - Street 2:BUILDING III, SUITE 603
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6723
Practice Address - Country:US
Practice Address - Phone:512-773-1279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty