Individual
MR. ELIJAH CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
60 N MAIN ST, 3RD FLR, WATERBURY, CT 06702-1443
(203) 437-8896
Mailing address
60 N MAIN ST, 3RD FLR., WATERBURY, CT 06702-1443
(203) 437-8896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008201
CT
363LF0000X
Family Nurse Practitioner
5149
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004040655
—
CT
05
—
008042640
—
CT
Enumeration date
09/23/2008
Last updated
01/11/2017
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