Provider Demographics
NPI:1639054158
Name:CALLAHAN, KAITLYN (CSWI)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E RIO BLANCO AVE
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-3203
Mailing Address - Country:US
Mailing Address - Phone:435-790-3746
Mailing Address - Fax:
Practice Address - Street 1:516 E RIO BLANCO AVE
Practice Address - Street 2:
Practice Address - City:RANGELY
Practice Address - State:CO
Practice Address - Zip Code:81648-3203
Practice Address - Country:US
Practice Address - Phone:435-790-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker