Provider Demographics
NPI:1689070567
Name:CARDWELL THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CARDWELL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:678-948-5526
Mailing Address - Street 1:546 TENSAS TRCE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-5832
Mailing Address - Country:US
Mailing Address - Phone:678-566-1939
Mailing Address - Fax:
Practice Address - Street 1:546 TENSAS TRCE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-5832
Practice Address - Country:US
Practice Address - Phone:678-566-1939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty