Provider Demographics
NPI:1366020174
Name:CALDWELL-PINEDA, MARY (LMFT NC #1826)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CALDWELL-PINEDA
Suffix:
Gender:F
Credentials:LMFT NC #1826
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4526
Mailing Address - Country:US
Mailing Address - Phone:920-901-8416
Mailing Address - Fax:
Practice Address - Street 1:130 EXECUTIVE DRIVE
Practice Address - Street 2:STE. 202
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2751
Practice Address - Country:US
Practice Address - Phone:920-901-8416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist