Provider Demographics
NPI:1457802910
Name:CALDWELL, CANDI
Entity Type:Individual
Prefix:
First Name:CANDI
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDI
Other - Middle Name:
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:493 1/2 ASPEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-8374
Mailing Address - Country:US
Mailing Address - Phone:614-499-4381
Mailing Address - Fax:
Practice Address - Street 1:200 GRAND AVE
Practice Address - Street 2:204
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7836
Practice Address - Country:US
Practice Address - Phone:970-712-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health