Provider Demographics
NPI:1013729474
Name:CALLAHAN, CHRISTINE CAMPBELL (PHD, MSW)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CAMPBELL
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 KNOLLWOOD HOLW
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2564
Mailing Address - Country:US
Mailing Address - Phone:703-772-6046
Mailing Address - Fax:
Practice Address - Street 1:38 KNOLLWOOD HOLW
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2564
Practice Address - Country:US
Practice Address - Phone:703-772-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD091391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical