Provider Demographics
NPI:1447453030
Name:CALDWELL, CRAIG VINCENT (LICSW)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:VINCENT
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COVES END RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1141
Mailing Address - Country:US
Mailing Address - Phone:508-524-1432
Mailing Address - Fax:
Practice Address - Street 1:14 COVES END RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1141
Practice Address - Country:US
Practice Address - Phone:508-524-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10247681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical