Provider Demographics
NPI:1790275758
Name:CALLENDER, LEARIE H (MSW)
Entity Type:Individual
Prefix:MR
First Name:LEARIE
Middle Name:H
Last Name:CALLENDER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HAWTHORNE GROVES BLVD APT 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6872
Mailing Address - Country:US
Mailing Address - Phone:321-203-9123
Mailing Address - Fax:407-313-0760
Practice Address - Street 1:270 HAWTHORNE GROVES BLVD APT 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6872
Practice Address - Country:US
Practice Address - Phone:321-203-9123
Practice Address - Fax:407-313-0760
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW12234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health