Individual
BRANDON ROSS CAULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A, LCSWA
Contact information
Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28472
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
MHL-065-011
NC
1041C0700X
Clinical Social Worker
MHL-065-011
NC
1041C0700X
Clinical Social Worker
P019596
NC
171M00000X
Case Manager/Care Coordinator
MHL-065-011
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300416T
—
NC
Enumeration date
08/29/2022
Last updated
08/24/2023
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