Provider Demographics
NPI: | 1467336305 |
---|---|
Name: | CALDWELL, STARR (EDD, SED,LBS1&2) |
Entity type: | Individual |
Prefix: | DR |
First Name: | STARR |
Middle Name: | |
Last Name: | CALDWELL |
Suffix: | |
Gender: | F |
Credentials: | EDD, SED,LBS1&2 |
Other - Prefix: | |
Other - First Name: | STARR |
Other - Middle Name: | |
Other - Last Name: | PERDUE |
Other - Suffix: | |
Other - Last Name Type: | Professional Name |
Other - Credentials: | DUAL EDD, ESL,PERA |
Mailing Address - Street 1: | 302 E CARSON AVE FL 10 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89101-5905 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 725-705-7421 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 302 E CARSON AVE FL 10 |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89101-5905 |
Practice Address - Country: | US |
Practice Address - Phone: | 725-705-7421 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2025-08-04 |
Last Update Date: | 2025-09-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NV | 171M00000X, 103K00000X, 261QM0801X, 251S00000X, 101YP2500X, 103TP2701X, 225C00000X, 251300000X, 261QM0850X, 320900000X, 101YM0800X, 104100000X, 261QM1300X, 103TS0200X, 103TA0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No | 225C00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | |
No | 251300000X | Agencies | Local Education Agency (LEA) | |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School |
No | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |