Provider Demographics
NPI:1578824223
Name:CALETKA, BRIDGET KILEY (LPC)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:KILEY
Last Name:CALETKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N BENTON WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1513
Mailing Address - Country:US
Mailing Address - Phone:607-237-3938
Mailing Address - Fax:
Practice Address - Street 1:23 N BENTON WOODS CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1513
Practice Address - Country:US
Practice Address - Phone:607-237-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP83212101YM0800X
TX70914101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health