Provider Demographics
NPI:1922516293
Name:CALLAWAY, MARY KATHERINE (LMSW)
Entity Type:Individual
Prefix:
First Name:MARY KATHERINE
Middle Name:
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WILD BASIN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-3341
Mailing Address - Country:US
Mailing Address - Phone:512-246-7225
Mailing Address - Fax:512-605-3732
Practice Address - Street 1:205 WILD BASIN RD STE 202
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-246-7225
Practice Address - Fax:512-605-3732
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker