Provider Demographics
NPI:1023252467
Name:CALDWELL, TEISHA KAY (MED)
Entity type:Individual
Prefix:MS
First Name:TEISHA
Middle Name:KAY
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 COOK ST
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8693
Mailing Address - Country:US
Mailing Address - Phone:505-709-8493
Mailing Address - Fax:
Practice Address - Street 1:458 COOK ST
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8693
Practice Address - Country:US
Practice Address - Phone:505-709-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0153601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional