MEDICARE: GRACE CALLAHAN

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
1	235Z00000X	Speech-Language Pathologist	4141	KS
2	235Z00000X	Speech-Language Pathologist	2025027562	MO

General Provider Information

NPI Number	:	1477443059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE CALLAHAN

Provider Business Mailing Address
First Line	:	13311 BALLENTINE ST.
Second Line	:	APARTMENT 11
City	:	OVERLAND PARK
State	:	KS
Zip	:	66213-4696
Country	:	US
Telephone Number	:	314-705-6419
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 PARK AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64109-2532
Country	:	US
Telephone Number	:	816-418-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	08/18/2025

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Directions to “ GRACE CALLAHAN ” Practice Location

Language	Start Address	Practice Location

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