Provider Demographics
NPI:1043821747
Name:CALLAHAN, ANNETTE M (LPC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 E BRIARWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7843
Mailing Address - Country:US
Mailing Address - Phone:480-529-3835
Mailing Address - Fax:
Practice Address - Street 1:3229 E BRIARWOOD TER
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7843
Practice Address - Country:US
Practice Address - Phone:480-529-3835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-19136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health