Provider Demographics
NPI:1700096682
Name:CALDWELL, DENISE D (LCSW, RPT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:D
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 QUAKER MEETING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:PA
Mailing Address - Zip Code:17820-8708
Mailing Address - Country:US
Mailing Address - Phone:570-441-4623
Mailing Address - Fax:570-356-2206
Practice Address - Street 1:457 RIDGE ST
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-3371
Practice Address - Country:US
Practice Address - Phone:570-441-4623
Practice Address - Fax:570-356-2207
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0155491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical