Healthcare Provider Details
I. General information
NPI: 1548531916
Provider Name (Legal Business Name): ELIZABETH A O'CALLAHAN LMHC, BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2012
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 VICTORIA AVE
WORCESTER MA
01607-1506
US
IV. Provider business mailing address
14 VICTORIA AVE
WORCESTER MA
01607-1506
US
V. Phone/Fax
- Phone: 508-233-8586
- Fax: 774-366-0757
- Phone: 508-233-8586
- Fax: 774-366-0757
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LMHC13213 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | LABA1305 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: