Provider Demographics
NPI:1376429936
Name:CALLEJO, CHARLES MANUEL III (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MANUEL
Last Name:CALLEJO
Suffix:III
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:540 JOSLEN BLVD APT 117B
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1035
Mailing Address - Country:US
Mailing Address - Phone:845-616-2431
Mailing Address - Fax:
Practice Address - Street 1:160 FAIRVIEW AVE STE 99
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-8404
Practice Address - Country:US
Practice Address - Phone:518-245-6272
Practice Address - Fax:518-721-8343
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1006941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical