Provider Demographics
NPI:1578717666
Name:CALDWELL, STACY (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CREEKSIDE DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-9219
Mailing Address - Country:US
Mailing Address - Phone:484-925-0990
Mailing Address - Fax:
Practice Address - Street 1:400 CREEKSIDE DR
Practice Address - Street 2:SUITE 403
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9219
Practice Address - Country:US
Practice Address - Phone:484-925-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126762104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker