Provider Demographics
NPI:1457677742
Name:CALLEN, DOUGLAS G (CCJP)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:G
Last Name:CALLEN
Suffix:
Gender:M
Credentials:CCJP
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Mailing Address - Street 1:793 OLD ROUTE 119 HWY N
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1372
Mailing Address - Country:US
Mailing Address - Phone:724-465-5576
Mailing Address - Fax:724-465-6379
Practice Address - Street 1:100 CALDWELL DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1152
Practice Address - Country:US
Practice Address - Phone:814-371-1100
Practice Address - Fax:814-371-3671
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)