Provider Demographics
NPI:1760248173
Name:CALDWELL, EARLENE SMITH (LPC)
Entity Type:Individual
Prefix:
First Name:EARLENE
Middle Name:SMITH
Last Name:CALDWELL
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 1:5006 PLANTATION LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5107
Mailing Address - Country:US
Mailing Address - Phone:469-486-1202
Mailing Address - Fax:
Practice Address - Street 1:5300 TOWN AND COUNTRY BLVD STE 240
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1008
Practice Address - Country:US
Practice Address - Phone:469-486-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional