Individual
JAY CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LADC
Contact information
Practice address
1150 MONTREAL AVE STE 107, SAINT PAUL, MN 55116-2393
(651) 313-0096
Mailing address
1150 MONTREAL AVE STE 107, SAINT PAUL, MN 55116-2393
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304218
MN
101YM0800X
Mental Health Counselor
Primary
1608
MN
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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