Provider Demographics
NPI:1124440904
Name:CALDWELL, ANNA I (PHD, LCSW, LCAC)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:CALDWELL
Suffix:I
Gender:F
Credentials:PHD, LCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 N PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1020
Mailing Address - Country:US
Mailing Address - Phone:317-686-9784
Mailing Address - Fax:317-686-9870
Practice Address - Street 1:927 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1020
Practice Address - Country:US
Practice Address - Phone:317-686-9784
Practice Address - Fax:317-686-9870
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004632A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical