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Individual
PHILLIP GENTRY CALDWELL
Active
Individual
PHILLIP GENTRY CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005530
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108
CAREFIRST BCBS
VA
01
—
188809
ANTHEM
VA
01
—
299089
AMERIGROUP VIRGINIA, INC
VA
Enumeration date
12/21/2006
Last updated
07/08/2007
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