Healthcare Provider Details

I. General information

NPI: 1861681785
Provider Name (Legal Business Name): KRISTEN CALDWELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 E 31ST ST
TULSA OK
74135-5012
US

IV. Provider business mailing address

5310 E 31ST ST
TULSA OK
74135-5012
US

V. Phone/Fax

Practice location:
  • Phone: 918-600-3100
  • Fax:
Mailing address:
  • Phone: 918-600-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13273
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2002010853
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: