Micah Caldwell Therapy PLLC
Clinic/Center, Adult Mental Health in Berwyn, IL. Organization (NPI-2).
NPI number1376230656
StatusActive
Last updated in NPPESApr 18, 2023
Details
- NPI
- 1376230656
- Entity type
- Organization (NPI-2)
- Legal business name
- Micah Caldwell Therapy PLLC
- Organization subpart
- No
- Enumeration date
- Apr 18, 2023
- Certification date
- Apr 18, 2023
- Last updated
- Apr 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
Practice location
3440 Clinton AveBerwyn, IL 60402-3322
Phone 708-695-4841
Mailing address
7301 W 25th St # 130North Riverside, IL 60546-1409
Authorized official
Micah Caldwell
Owner/Therapist
7086954841
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