Provider Demographics
NPI:1740563113
Name:ANDERSON-CALDWELL, HOLLY LEANNE (LCSW, CDC I)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LEANNE
Last Name:ANDERSON-CALDWELL
Suffix:
Gender:F
Credentials:LCSW, CDC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 NE ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-1585
Mailing Address - Country:US
Mailing Address - Phone:907-250-6887
Mailing Address - Fax:
Practice Address - Street 1:3300 ARTIC BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4579
Practice Address - Country:US
Practice Address - Phone:907-250-6887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW612590401041C0700X
ORL77981041C0700X
AK9251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical