Provider Demographics
NPI:1952681744
Name:CALDWELL, BOBBIE BAILEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:BAILEY
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MALLARD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2348
Mailing Address - Country:US
Mailing Address - Phone:318-791-9989
Mailing Address - Fax:318-325-9564
Practice Address - Street 1:3209 S GRAND ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-5225
Practice Address - Country:US
Practice Address - Phone:318-388-1104
Practice Address - Fax:318-325-9564
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA28381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical