Healthcare Provider Details

I. General information

NPI: 1851143150
Provider Name (Legal Business Name): JENNIFER CALDWELL MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S HUDSON ST STE 12
SILVER CITY NM
88061-6184
US

IV. Provider business mailing address

PO BOX 1349
SILVER CITY NM
88062-1349
US

V. Phone/Fax

Practice location:
  • Phone: 575-388-4497
  • Fax:
Mailing address:
  • Phone: 575-522-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0221
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2024-0221
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: