Provider Demographics
NPI:1245382712
Name:CALLANS, JUDY ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:ANN
Last Name:CALLANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 FRONTAGE RD
Mailing Address - Street 2:SUITE 28
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093
Mailing Address - Country:US
Mailing Address - Phone:847-501-2794
Mailing Address - Fax:
Practice Address - Street 1:456 W FRONTAGE RD
Practice Address - Street 2:SUITE 28
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3034
Practice Address - Country:US
Practice Address - Phone:847-501-2794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker