Provider Demographics
NPI:1093026825
Name:CALDWELL, ANNA ROSE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:ROSE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-1763
Mailing Address - Country:US
Mailing Address - Phone:540-641-3040
Mailing Address - Fax:540-260-9071
Practice Address - Street 1:106 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-1539
Practice Address - Country:US
Practice Address - Phone:540-641-3040
Practice Address - Fax:540-260-9071
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-26
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000209103K00000X
VA09040073841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty