1801303094 NPI number — MARY LEIGH CALDWELL LCMHC

Table of content: MARY LEIGH CALDWELL LCMHC (NPI 1801303094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801303094 NPI number — MARY LEIGH CALDWELL LCMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALDWELL
Provider First Name:
MARY
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CALDWELL
Provider Other First Name:
MOLLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCMHC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801303094
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 WOODFIN PLACE
Provider Second Line Business Mailing Address:
WEST WING SUITE 6C
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-571-0548
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 WOODFIN PLACE
Provider Second Line Business Practice Location Address:
SUITE 6C
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-3812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-571-0548
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/09/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  13555 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)