Provider Demographics
NPI:1093991531
Name:CALLAHAN PC
Entity Type:Organization
Organization Name:CALLAHAN PC
Other - Org Name:NEUROPSYCHOLOGICAL CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-301-5188
Mailing Address - Street 1:14067 HARTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-5103
Mailing Address - Country:US
Mailing Address - Phone:402-301-5188
Mailing Address - Fax:402-552-2655
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:SUITE 655
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2806
Practice Address - Country:US
Practice Address - Phone:402-552-2665
Practice Address - Fax:402-552-2655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty