Provider Demographics
NPI:1598876633
Name:CALDWELL, CAROLINE D (MA, ABD)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:D
Last Name:CALDWELL
Suffix:
Gender:
Credentials:MA, ABD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 INGLEAOK LANE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3151
Mailing Address - Country:US
Mailing Address - Phone:864-551-8241
Mailing Address - Fax:864-751-5232
Practice Address - Street 1:709 DUNBAR STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4011
Practice Address - Country:US
Practice Address - Phone:864-509-1014
Practice Address - Fax:864-751-5232
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC301100Medicaid