Provider Demographics
NPI:1760698427
Name:CALLAHAN, KATHRYN (LCSW, CASAC, CEAP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LCSW, CASAC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 JOHN CAVA LN
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-6306
Mailing Address - Country:US
Mailing Address - Phone:914-739-7022
Mailing Address - Fax:
Practice Address - Street 1:35 E GRASSY SPRAIN RD
Practice Address - Street 2:SUITE LL #3
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4620
Practice Address - Country:US
Practice Address - Phone:914-337-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2882101YA0400X
NY56692961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical