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General NPI Number Information
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NPI Number | 1306394283
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Entity Type | Individual
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Provider Name | DANIEL J. CALLAHAN MCAP, MSW, ICRC-ADC
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Gender | Male
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 18070 S TAMIAMI TRL STE 11
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City | FORT MYERS
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State | FL
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Zip | 33908-4602
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Country | US
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Telephone | 239-687-9198
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Fax |
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Provider Business Mailing Address
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Address Line | 18070 S TAMIAMI TRL STE 11
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City | FORT MYERS
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State | FL
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Zip | 33908-4602
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Country | US
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Telephone | 239-687-9198
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 100046
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP100046
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License Number State | FL
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