Healthcare Provider Details

I. General information

NPI: 1801674031
Provider Name (Legal Business Name): MAEVE CALLAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FEDERAL ST
SPRINGFIELD MA
01105-1199
US

IV. Provider business mailing address

1 FEDERAL ST
SPRINGFIELD MA
01105-1199
US

V. Phone/Fax

Practice location:
  • Phone: 413-737-9544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: