Provider Demographics
NPI:1043682511
Name:CALAHAN, BARRY
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:CALAHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GRAMBLING
Mailing Address - State:LA
Mailing Address - Zip Code:71245-3116
Mailing Address - Country:US
Mailing Address - Phone:318-533-0661
Mailing Address - Fax:318-259-1580
Practice Address - Street 1:103 4TH ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-3346
Practice Address - Country:US
Practice Address - Phone:318-259-1500
Practice Address - Fax:318-259-1580
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst