| Caldwell Family Counseling, Llc | |
|
457 Ridge St Bloomsburg PA 17815-3371 | |
| (570) 441-4623 | |
| (570) 356-2207 |
| Full Name | Caldwell Family Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 457 Ridge St, Bloomsburg, Pennsylvania |
| Authorized Official Name and Position | Denise Diane Caldwell (OWNER) |
| Authorized Official Contact | 5704414623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Family Counseling, Llc Po Box 692 Bloomsburg PA 17815-0692 Ph: (570) 441-4623 | Caldwell Family Counseling, Llc 457 Ridge St Bloomsburg PA 17815-3371 Ph: (570) 441-4623 |
| NPI Number | 1790080331 |
|---|---|
| Provider Enumeration Date | 01/12/2011 |
| Last Update Date | 08/06/2015 |
| Medicare PECOS PAC ID | 2466634886 |
|---|---|
| Medicare Enrollment ID | O20110307000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790080331 | NPI | - | NPPES |
| 1019912710001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CW015549 (Pennsylvania) | Primary |
| Provider Name | Denise Diane Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700096682 PECOS PAC ID: 3375725799 Enrollment ID: I20110307000606 |
| Provider Name | Maurissa Ann Laudeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497388854 PECOS PAC ID: 6901206630 Enrollment ID: I20210616002668 |
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