Provider Demographics
NPI:1508453986
Name:CALDWELL, TONI J (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:J
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:21102 FOX WALK TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-1481
Mailing Address - Country:US
Mailing Address - Phone:281-704-5539
Mailing Address - Fax:281-913-5000
Practice Address - Street 1:21102 FOX WALK TRL
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-1481
Practice Address - Country:US
Practice Address - Phone:281-674-4518
Practice Address - Fax:281-913-5000
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4185357Medicaid