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NPI Code Detail

MEDICARE: KRISTALEE CALDWELL LCSWA

MEDICARE: KRISTALEE CALDWELL LCSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP020657NC

General Provider Information

NPI Number : 1770935553
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTALEE CALDWELL LCSWA
Provider Business Mailing Address
First Line : 280 EXECUTIVE PARK DR STE 100
Second Line :
City : CONCORD
State : NC
Zip : 28025-1838
Country : US
Telephone Number : 207-237-4240
Fax Number : 704-785-8304
Provider Business Practice Location Address
First Line : 280 EXECUTIVE PARK DR STE 100
Second Line :
City : CONCORD
State : NC
Zip : 28025-1838
Country : US
Telephone Number : 207-237-4240
Fax Number : 704-785-8304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2016
Last Update Date : 07/05/2024

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Directions to “ KRISTALEE CALDWELL LCSWA” Practice Location

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