MEDICARE: MS. TRICIA A CALLAWAY LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	116948	MA
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1336329168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRICIA A CALLAWAY LICSW

Provider Business Mailing Address
First Line	:	237 HIGHLAND RD
Second Line	:
City	:	ANDOVER
State	:	MA
Zip	:	01810-1914
Country	:	US
Telephone Number	:	484-433-9442
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 MERRIMAC ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-4714
Country	:	US
Telephone Number	:	484-433-9442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	03/08/2023

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