| Caldwell Psychotherapy Center, Pc | |
|
1984 Isaac Newton Sq W Ste 204 Reston VA 20190-5040 | |
| (703) 863-6140 | |
| Not Available |
| Full Name | Caldwell Psychotherapy Center, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1984 Isaac Newton Sq W Ste 204, Reston, Virginia |
| Authorized Official Name and Position | Robert David Caldwell (OWNER) |
| Authorized Official Contact | 2022988311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Psychotherapy Center, Pc 1984 Isaac Newton Sq W Ste 204 Reston VA 20190-5040 Ph: (703) 863-6140 | Caldwell Psychotherapy Center, Pc 1984 Isaac Newton Sq W Ste 204 Reston VA 20190-5040 Ph: (703) 863-6140 |
| NPI Number | 1255512307 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 09/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255512307 | NPI | - | NPPES |
| 766367ZBR9 G02714 | Other | DC | MEDICARE PTAN |
| 766367ZBR9 G02714 | Other | VA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC302452 (District Of Columbia) | Secondary |
| 1041C0700X | Social Worker - Clinical | 090400280 (Virginia) | Primary |
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