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NPI Code Detail

MEDICARE: PETER JOSEPH CALLAHAN LGSW

MEDICARE: PETER JOSEPH CALLAHAN LGSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerDP09966148WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205834389
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER JOSEPH CALLAHAN LGSW
Provider Business Mailing Address
First Line : PO BOX 1074
Second Line :
City : MARTINSBURG
State : WV
Zip : 25402-1074
Country : US
Telephone Number : 304-886-4118
Fax Number : 304-579-8606
Provider Business Practice Location Address
First Line : 1020 WINCHESTER AVE
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-1650
Country : US
Telephone Number : 304-886-4118
Fax Number : 304-579-8606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 11/18/2019

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1760127559 — LAUREL HARDING MSW, LGSW, AADC, MAC
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1972343721 — ANNA WHITTINGTON
Practice Location Address:
1020 WINCHESTER AVE
MARTINSBURG, WV
25401-1650
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1215752951 — CALLAHAN COUNSELING
Practice Location Address:
1020 WINCHESTER AVE
MARTINSBURG, WV
25401-1650
Practice Phone: 304-886-4118
Practice Fax: 304-579-8606

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