Provider Demographics
NPI:1184806739
Name:CALLAWAY, ABIGAIL BELLE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:BELLE
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10224 DAY AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2727
Mailing Address - Country:US
Mailing Address - Phone:415-722-0049
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE, BLDG 19, 6TH FLOOR
Practice Address - Street 2:DEFENSE & VETERANS BRAIN INJURY CENTER, WALTER REED
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4766
Practice Address - Fax:301-295-4759
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC50078407104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker