Active NPI
Connie Caldwell
- Addiction (Substance Use Disorder) Counselor
- Longview, TX
National Provider Identifier
1164711677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2669
- Practice address
- 708 Glencrest LN
Longview, TX 75601-5137 - Phone
- (903) 753-7633
- NPI assigned
- Apr 5, 2011
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2669 | TX | Primary |
Addresses
Primary practice location
708 Glencrest LN
Longview, TX 75601-5137
Mailing address
708 Glencrest LN
Longview, TX 75601-5137
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 |
|---|---|---|---|
| 2669 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Council on Alcoholism and Drug Abuse | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Longview, TX
- NPI 1679862569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1164711677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 GLENCREST LN",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 GLENCREST LN",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015137",
"telephone_number": "903-753-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDWELL",
"first_name": "CONNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-05",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "2669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.