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Individual
SUSAN KENNEDY CALLAHAN
Active
Individual
SUSAN KENNEDY CALLAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C290
IN
1041C0700X
Clinical Social Worker
Primary
34001266
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
05/15/2006
Last updated
03/26/2014
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