Provider Demographics
NPI:1568967040
Name:CALDWELL, DANA LYNN (CDCA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 AIRPORT DR STE 130A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2473
Mailing Address - Country:US
Mailing Address - Phone:614-407-9048
Mailing Address - Fax:614-351-2010
Practice Address - Street 1:2760 AIRPORT DR STE 130A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2473
Practice Address - Country:US
Practice Address - Phone:614-407-9048
Practice Address - Fax:614-351-2010
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII161795101YA0400X
OHCDCA120674101YA0400X
OH171M00000X
OHLCDCIII.161795101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator