Individual
NEISHA CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1410 NE 106TH AVE, PORTLAND, OR 97220-3934
(503) 460-0405
Mailing address
8007 SE OTTY ST, MILWAUKIE, OR 97222-1073
(503) 875-4836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L7563
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548330715
—
OR
Enumeration date
08/12/2013
Last updated
03/17/2018
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