Healthcare Provider Details

I. General information

NPI: 1316935059
Provider Name (Legal Business Name): CARRIE ANN CADWELL PSY.D.,HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N MICHIGAN ST SUITE 204
PLYMOUTH IN
46563-1770
US

IV. Provider business mailing address

15050 BAINBRIDGE CT
WESTFIELD IN
46074-8871
US

V. Phone/Fax

Practice location:
  • Phone: 574-936-3031
  • Fax: 574-936-3031
Mailing address:
  • Phone: 574-485-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042025A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: