Provider Demographics
NPI:1437382785
Name:CALDWELL, BELA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BELA
Middle Name:ANN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5008 NAILS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-2333
Mailing Address - Country:US
Mailing Address - Phone:912-282-4996
Mailing Address - Fax:912-367-7317
Practice Address - Street 1:5008 NAILS FERRY RD
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-2333
Practice Address - Country:US
Practice Address - Phone:912-282-4996
Practice Address - Fax:912-367-7317
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0038951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical