Provider Demographics
NPI:1689796690
Name:O'CALLAGHAN, JAMES BRIEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIEN
Last Name:O'CALLAGHAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:BRIEN
Other - Last Name:O'CALLAGHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:54 PLUMTREES RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1645
Mailing Address - Country:US
Mailing Address - Phone:203-743-1633
Mailing Address - Fax:203-791-8300
Practice Address - Street 1:246 FEDERAL RD STE 24
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-740-2595
Practice Address - Fax:203-740-2287
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000930103TC0700X
CT000101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTR89312Medicare UPIN