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General NPI Number Information
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NPI Number | 1821546151
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Entity Type | Organization
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Legal Business Name | JOSEPH P CALLAN LCSW
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 5745 MAIN ST SUITE 204
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2737
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Country | US
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Telephone | 813-924-0488
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 LAKE PADGETT DR
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City | LAND O LAKES
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State | FL
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Zip | 34639-6514
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Country | US
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Telephone | 813-924-0488
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH CALLAN
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Credential | LCSW
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Telephone | 813-924-0488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | SW1785
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License Number State | FL
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