Active NPI
Khaalisha Idrina Caldwell, P-LCSW
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1073833091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P005669
- Practice address
- 8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350 - Phone
- (704) 596-5553
- NPI assigned
- Jun 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P005669 | NC | Primary |
Addresses
Primary practice location
8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350
Mailing address
8430 University Exec Park Dr
Suite 655
Charlotte, NC 28262-1350
Phone (704) 596-5553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P005669 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275436800000",
"number": "1073833091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8430 UNIVERSITY EXEC PARK DR",
"address_2": "SUITE 655",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621350",
"telephone_number": "704-596-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8430 UNIVERSITY EXEC PARK DR",
"address_2": "SUITE 655",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621350",
"telephone_number": "704-596-5553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDWELL",
"first_name": "KHAALISHA",
"middle_name": "IDRINA",
"name_prefix": "Ms.",
"credential": "P-LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-02",
"last_updated": "2010-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P005669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
- David Nathaniel Caldwell, PHARMD
- Dorene Katherine Caldwell, MSN, PMHNP-BC
- Frank Caldwell, LMT
- Georgia Caldwell, B.S. , CADC
- Jenny Lynne Caldwell, MA, LMFTA
- McKenzie Gabrielle Caldwell, MPH, RDN
- Melissa Kaye Caldwell, NP
- Richard Kent Caldwell, DDS
- Ryan Blaine Caldwell, M.D.
- Saiona Anita Caldwell, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.