Healthcare Provider Details

I. General information

NPI: 1275208738
Provider Name (Legal Business Name): ANITA RENEE CALAHAN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 NEEDMORE RD
DAYTON OH
45414-3808
US

IV. Provider business mailing address

1914 NEEDMORE RD
DAYTON OH
45414-3808
US

V. Phone/Fax

Practice location:
  • Phone: 937-838-8319
  • Fax:
Mailing address:
  • Phone: 937-838-8319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberS.1450970
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberS.1450970
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberS.1450970
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberS.1450970
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1450970
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberS.1450970
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberS.1450970
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: