Healthcare Provider Details

I. General information

NPI: 1689510786
Provider Name (Legal Business Name): DEVIN LYNN CALDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 FAIRFAX BLVD STE 207
FAIRFAX VA
22030-5017
US

IV. Provider business mailing address

9400 MEADOW CROSSING WAY
FAIRFAX STATION VA
22039-3320
US

V. Phone/Fax

Practice location:
  • Phone: 918-407-6280
  • Fax:
Mailing address:
  • Phone: 918-407-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: