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General NPI Number Information
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NPI Number | 1346323730
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Entity Type | Individual
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Provider Name | LISA MICHELLE CALLOWAY LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 9748 S ROBERTS RD STE 2
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City | PALOS HILLS
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State | IL
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Zip | 60465-1495
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Country | US
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Telephone | 630-866-0315
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Fax | 630-596-4549
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Provider Business Mailing Address
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Address Line | PO BOX 428247
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-8247
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Country | US
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Telephone | 630-272-6240
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Fax | 630-364-2555
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.009437
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License Number State | IL
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