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General NPI Number Information
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NPI Number | 1386770436
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Entity Type | Individual
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Provider Name | NAN CALLAN LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 950 1ST ST S SUITE 205
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City | WINTER HAVEN
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State | FL
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Zip | 33880-3665
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Country | US
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Telephone | 863-299-8400
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Fax | 863-293-4378
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Provider Business Mailing Address
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Address Line | 120 HOMEWOOD DR
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1508
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Country | US
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Telephone | 863-294-8416
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Fax | 863-293-4378
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 1910
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License Number State | FL
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