Healthcare Provider Details

I. General information

NPI: 1538017181
Provider Name (Legal Business Name): GEORGIA CALLAHAN, LICSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WHITNEY AVE APT 2R
BEVERLY MA
01915-3452
US

IV. Provider business mailing address

230 INDEPENDENCE WAY STE 1
DANVERS MA
01923-3692
US

V. Phone/Fax

Practice location:
  • Phone: 978-991-1763
  • Fax:
Mailing address:
  • Phone: 978-991-1763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GEORGIANA CALLAHAN
Title or Position: OWNER
Credential: LICSW, PMH-C
Phone: 401-855-5997