Provider Demographics
NPI:1639288384
Name:CALLAWAY, ELIZABETH SPENCER (LPC LMFT LCDC SPMA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SPENCER
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:LPC LMFT LCDC SPMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8600 WURZBACH
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240
Mailing Address - Country:US
Mailing Address - Phone:210-822-5971
Mailing Address - Fax:830-336-4668
Practice Address - Street 1:8600 WURZBACH
Practice Address - Street 2:SUITE 1103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-822-5971
Practice Address - Fax:830-336-4668
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3206101YA0400X
TX2906101YP2500X
TX81106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLP0012697Medicare ID - Type Unspecified