MEDICARE: MS. DEBORAH JANE CALLAHAN LCSW

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	1041C0700X	Clinical Social Worker	CW016690	PA

General Provider Information

NPI Number	:	1871981449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH JANE CALLAHAN LCSW

Provider Business Mailing Address
First Line	:	143 CARPENTER LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2528
Country	:	US
Telephone Number	:	484-432-2601
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 WALNUT ST STE 1708
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4717
Country	:	US
Telephone Number	:	215-745-2192
Fax Number	:

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

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	09/15/2020

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