Provider Demographics
NPI:1740593086
Name:CALDWELL, JULIE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 W LINKS DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-2737
Mailing Address - Country:US
Mailing Address - Phone:602-791-0894
Mailing Address - Fax:
Practice Address - Street 1:39905 N GAVILAN PEAK PKWY
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-2521
Practice Address - Country:US
Practice Address - Phone:602-791-0894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10298106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist