Provider Demographics
NPI:1659718633
Name:CALDWELL, MARCY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARCY
Other - Middle Name:CALDWELL
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2216 RITTENHOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5505
Mailing Address - Country:US
Mailing Address - Phone:610-724-7010
Mailing Address - Fax:
Practice Address - Street 1:505 S 22ND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1246
Practice Address - Country:US
Practice Address - Phone:610-724-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016507103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist