BRENTIA J CALDWELL


Address: 3205 River Shoals Cv, Decatur, GA 30034-6778
Phone: 4047979755

BRENTIA J CALDWELL (NPI# 1295386423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295386423
Entity Type Individual
Full Name BRENTIA J CALDWELL
Credential ED.S., LPC
Practice Address 3205 River Shoals Cv
Decatur
GA 30034-6778
Practice Telephone 4047979755
Mailing Telephone 4047979755
Enumeration Date 2019-09-29
Last Update Date 2019-09-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
LPC009978 GA Behavioral Health & Social Service Providers

Office Location

Street Address 3205 RIVER SHOALS CV
City DECATUR
State GA
Zip Code 30034-6778

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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1851925218 Nikkita Nelson Counselor 315 W Ponce De Leon Ave Ste 300, Decatur, GA 30030-2481 2020-02-25
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1588208979 Amanda Nesbitt Counselor 173 Pine Tree Cir, Decatur, GA 30032-1145 2019-10-29
1861044703 Latasha Heinzen Counselor 2042 Beltline Rd Suite 120a, Decatur, AL 35602 2019-07-11
1831757418 Jessica Stewart Counselor 755 Commerce Dr Ste 903, Decatur, GA 30030 2019-05-30
1386107811 Chardonnay Patterson Counselor 3629 Occidental Ct, Decatur, GA 30034-5502 2019-04-11
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Competitor

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City DECATUR
Zip Code 30034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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