Healthcare Provider Details

I. General information

NPI: 1508878299
Provider Name (Legal Business Name): CALLAN BARRETT MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 MAIN ST
FREELAND WA
98249
US

IV. Provider business mailing address

PO BOX 593
LANGLEY WA
98260-0593
US

V. Phone/Fax

Practice location:
  • Phone: 360-221-0901
  • Fax:
Mailing address:
  • Phone: 360-221-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1189
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60407922
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: