Provider Demographics
NPI:1356747372
Name:CALDWELL, CELIA ELAINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:ELAINE
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 1:10905 BUTLER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-9082
Mailing Address - Country:US
Mailing Address - Phone:406-728-4856
Mailing Address - Fax:
Practice Address - Street 1:10905 BUTLER CREEK RD
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-9082
Practice Address - Country:US
Practice Address - Phone:406-728-4856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT89881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical