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NPI Code Detail

MEDICARE: LIBERTY ELLEN CALLAHAN

MEDICARE: LIBERTY ELLEN CALLAHAN
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1588473649
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIBERTY ELLEN CALLAHAN
Provider Business Mailing Address
First Line : 50803 OLD INFIRMARY RD
Second Line :
City : PLEASANT CITY
State : OH
Zip : 43772-9641
Country : US
Telephone Number : 740-509-2547
Fax Number :
Provider Business Practice Location Address
First Line : 10400 BLACKLICK EASTERN RD
Second Line :
City : PICKERINGTON
State : OH
Zip : 43147-8235
Country : US
Telephone Number : 740-509-2547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2025
Last Update Date : 03/10/2026

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Directions to “ LIBERTY ELLEN CALLAHAN ” Practice Location

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