Healthcare Provider Details

I. General information

NPI: 1609795343
Provider Name (Legal Business Name): CHRISTINE CALLOWAY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 PRINCESS JEANNE AVE NE
ALBUQUERQUE NM
87112-4426
US

IV. Provider business mailing address

PO BOX 20155
ALBUQUERQUE NM
87154-0155
US

V. Phone/Fax

Practice location:
  • Phone: 505-830-3128
  • Fax:
Mailing address:
  • Phone: 505-203-2260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberSWB-2026-0799
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2026-0799
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: