Provider Demographics
NPI:1932841251
Name:CALDWELL, MADISON SUGG (MSW)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:SUGG
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:GAYLE
Other - Last Name:SUGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:338 RAY ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-2820
Mailing Address - Country:US
Mailing Address - Phone:828-400-7286
Mailing Address - Fax:
Practice Address - Street 1:338 RAY ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2820
Practice Address - Country:US
Practice Address - Phone:828-400-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker