Provider Demographics
NPI:1326517871
Name:CALDWELL COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CALDWELL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCDAC
Authorized Official - Phone:270-699-1567
Mailing Address - Street 1:265 COUNTRY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-9286
Mailing Address - Country:US
Mailing Address - Phone:270-699-1567
Mailing Address - Fax:
Practice Address - Street 1:114 N SPALDING AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1517
Practice Address - Country:US
Practice Address - Phone:270-699-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100576910Medicaid