Provider Demographics
NPI:1871981449
Name:CALLAHAN, DEBORAH JANE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JANE
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 CARPENTER LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2528
Mailing Address - Country:US
Mailing Address - Phone:484-432-2601
Mailing Address - Fax:
Practice Address - Street 1:1315 WALNUT ST STE 1708
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4717
Practice Address - Country:US
Practice Address - Phone:215-745-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0166901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical