MEDICARE: SOPHIA CALLIHAM

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	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1669177796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA CALLIHAM

Provider Business Mailing Address
First Line	:	6601 RONALD RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 RONALD RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-4433
Country	:	US
Telephone Number	:	202-330-7327
Fax Number	:

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

Provider Enumeration Date	:	03/30/2023
Last Update Date	:	06/13/2023

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Directions to “ SOPHIA CALLIHAM ” Practice Location

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