Provider Demographics
NPI:1356924492
Name:CALAWAY, OLIMPIA (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:OLIMPIA
Middle Name:
Last Name:CALAWAY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MARY D AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5677
Mailing Address - Country:US
Mailing Address - Phone:210-336-7277
Mailing Address - Fax:
Practice Address - Street 1:100 MARY D AVE APT 6
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5677
Practice Address - Country:US
Practice Address - Phone:210-336-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional