Provider Demographics
NPI:1083393326
Name:ROLAND, CALLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:ROLAND
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 1:10207 SOUTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-5949
Mailing Address - Country:US
Mailing Address - Phone:254-291-5751
Mailing Address - Fax:
Practice Address - Street 1:10207 SOUTHSHORE DR
Practice Address - Street 2:
Practice Address - City:SALADO
Practice Address - State:TX
Practice Address - Zip Code:76571-5949
Practice Address - Country:US
Practice Address - Phone:254-291-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical