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General NPI Number Information
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NPI Number | 1942910344
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Entity Type | Individual
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Provider Name | ISHA CALDWELL LADC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1404 14TH AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55411-3111
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Country | US
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Telephone | 612-460-7693
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Fax |
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Provider Business Mailing Address
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Address Line | 106167 N 3800 RD
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City | OKEMAH
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State | OK
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Zip | 74859-5178
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Country | US
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Telephone | 612-460-7696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 305991
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4641
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License Number State | MN
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