Provider Demographics
NPI:1609356294
Name:CALDWELL, MADALYN TINIA (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:MADALYN
Middle Name:TINIA
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3937 KERRI CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2313
Mailing Address - Country:US
Mailing Address - Phone:334-220-2416
Mailing Address - Fax:
Practice Address - Street 1:4110 WALL ST STE C
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2925
Practice Address - Country:US
Practice Address - Phone:334-544-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional