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Individual

MRS. AMY MARIE CALLAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6729 MYRTLE AVE, GLENDALE, NY 11385-7063
(718) 456-7001
Mailing address
145 COMMUNITY DRIVE, MANHASSET, NY 11030

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
097993-1
NY
1041C0700X
Clinical Social Worker
Primary
093583
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00244624
NY
Enumeration date
08/28/2017
Last updated
11/12/2024
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