Organization Active NPI

Caldwell Family Counseling, LLC

  • Community/Behavioral Health Agency
  • Bloomsburg, PA
National Provider Identifier
1790080331
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CW015549 Issued in PA
Legal business name
CALDWELL FAMILY COUNSELING, LLC
Practice address
457 Ridge St
Bloomsburg, PA 17815-3371
Phone
(570) 441-4623
Fax
(570) 356-2207
NPI assigned
Jan 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denise Diane Caldwell, LCSWNPI 1700096682
Title
Owner
Phone
(570) 441-4623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CW015549 PA Primary

Addresses

Primary practice location

457 Ridge St
Bloomsburg, PA 17815-3371

Mailing address

PO Box 692
Bloomsburg, PA 17815-0692
Phone (570) 441-4623

Other identifiers 1

IdentifierTypeStateIssuer
1019912710001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110307000594 PA Part B Supplier - Clinic/Group Practice 2466634886 Receives reassigned benefits from 1 practitioner
Practice locations: Catawissa, PA

National Provider Directory

National Provider Directory

Locations

457 Ridge St
Bloomsburg, PA 17815
Phone (570) 244-4188

336 Main St
Catawissa, PA 17820
Phone (570) 356-2206

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1790080331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 692",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178150692",
            "telephone_number": "570-441-4623",
            "fax_number": "570-356-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 RIDGE ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153371",
            "telephone_number": "570-441-4623",
            "fax_number": "570-356-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL FAMILY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-441-4623",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "CW015549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019912710001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.