Individual
JODI SHAVER CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCAS
Contact information
Practice address
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103-6951
(336) 718-3550
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-3550
(336) 277-6981
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3063
NC
101YM0800X
Mental Health Counselor
Primary
9585
NC
101YP2500X
Professional Counselor
9585
NC
Other
Enumeration date
01/25/2012
Last updated
09/20/2024
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