Healthcare Provider Details

I. General information

NPI: 1770948143
Provider Name (Legal Business Name): EMILY CALLAHAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 SOLUTIONS WAY STE 120
ROCKLEDGE FL
32955-3623
US

IV. Provider business mailing address

1801 LAUREL OAK DR N
ROCKLEDGE FL
32955-3412
US

V. Phone/Fax

Practice location:
  • Phone: 321-320-3309
  • Fax:
Mailing address:
  • Phone: 954-319-6249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW14631
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: