Provider Demographics
NPI:1740578384
Name:J. CALLAHAN, LLC
Entity Type:Organization
Organization Name:J. CALLAHAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:469-662-0607
Mailing Address - Street 1:1702 N COLLINS BLVD
Mailing Address - Street 2:STE 190
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3566
Mailing Address - Country:US
Mailing Address - Phone:469-662-0607
Mailing Address - Fax:469-248-3635
Practice Address - Street 1:1755 N COLLINS BLVD
Practice Address - Street 2:#525
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3613
Practice Address - Country:US
Practice Address - Phone:469-662-0607
Practice Address - Fax:469-248-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty