Provider Demographics
NPI:1316935059
Name:CADWELL, CARRIE ANN (PSYD,HSPP)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANN
Last Name:CADWELL
Suffix:
Gender:F
Credentials:PSYD,HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15050 BAINBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8871
Mailing Address - Country:US
Mailing Address - Phone:574-485-4583
Mailing Address - Fax:
Practice Address - Street 1:310 N MICHIGAN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1770
Practice Address - Country:US
Practice Address - Phone:574-936-3031
Practice Address - Fax:574-936-3031
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042025A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000747271OtherBCBS
IN200800640AMedicaid
IN000000747271OtherBCBS