1174766232 NPI number — MS. CAROLYN THERESA CALLAHAN LSW, CEAP, ACSW

Table of content: MS. CAROLYN THERESA CALLAHAN LSW, CEAP, ACSW (NPI 1174766232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174766232 NPI number — MS. CAROLYN THERESA CALLAHAN LSW, CEAP, ACSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALLAHAN
Provider First Name:
CAROLYN
Provider Middle Name:
THERESA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSW, CEAP, ACSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174766232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CEDAR RIDGE DR
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15205-9691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-921-7000
Provider Business Mailing Address Fax Number:
412-921-7261

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 CEDAR RIDGE DR
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15205-9691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-921-7000
Provider Business Practice Location Address Fax Number:
412-921-7261
Provider Enumeration Date:
04/19/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  SW002387E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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