Provider Demographics
NPI:1730302167
Name:CALLOWAY, GINGER CONKLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:CONKLE
Last Name:CALLOWAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 WASHINGTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-3271
Mailing Address - Country:US
Mailing Address - Phone:919-834-8033
Mailing Address - Fax:919-834-6650
Practice Address - Street 1:855 WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-3271
Practice Address - Country:US
Practice Address - Phone:919-834-8033
Practice Address - Fax:919-834-6650
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC935103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist