MEDICARE: DR. MELODY BETH CALDWELL PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PS019482	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124789698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELODY BETH CALDWELL PSYD

Provider Business Mailing Address
First Line	:	4953 E WILLOCK RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15227-3659
Country	:	US
Telephone Number	:	412-350-8698
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 TOWN CENTER BLVD STE 142
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-5833
Country	:	US
Telephone Number	:	724-249-2829
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2022
Last Update Date	:	01/06/2022

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