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General NPI Number Information
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NPI Number | 1407710874
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Entity Type | Individual
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Provider Name | COREY CALLOWAY L COREY CALLOWAY
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Gender | Male
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1818 NEW YORK AVE NE STE 201
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City | WASHINGTON
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State | DC
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Zip | 20002-1849
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Country | US
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Telephone | 202-506-5187
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 RACHEL LN SW
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City | VIENNA
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State | VA
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Zip | 22180-6473
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Country | US
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Telephone | 803-470-8350
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Fax | 803-470-8350
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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