MEDICARE: MICHELLE CALLAGHAN

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

General Provider Information

NPI Number	:	1942154380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CALLAGHAN

Provider Business Mailing Address
First Line	:	401 S 2ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1612
Country	:	US
Telephone Number	:	267-715-0693
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 S RUBY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4928
Country	:	US
Telephone Number	:	917-318-7721
Fax Number	:

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

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	03/22/2026

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Directions to “ MICHELLE CALLAGHAN ” Practice Location

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