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General NPI Number Information
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NPI Number | 1780200618
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Entity Type | Organization
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Legal Business Name | CALDWELL COUNSELING CENTER
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 11999 KATY FWY STE 530
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City | HOUSTON
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State | TX
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Zip | 77079-1623
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Country | US
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Telephone | 832-443-2983
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Fax |
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Provider Business Mailing Address
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Address Line | 25611 PANNIER PL
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City | KATY
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State | TX
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Zip | 77493-3699
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Country | US
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Telephone | 832-326-6276
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | DAN NORMAN CALDWELL JR.
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Credential | MA, LCDC-CCS, ADC
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Telephone | 832-326-6276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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