Provider Demographics
NPI:1518978410
Name:CALLANAN, ANN E (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:E
Last Name:CALLANAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PHEASANT HILL DR
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3213
Mailing Address - Country:US
Mailing Address - Phone:781-545-1554
Mailing Address - Fax:
Practice Address - Street 1:62 DERBY ST
Practice Address - Street 2:SUITE 13
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-749-4600
Practice Address - Fax:781-741-8341
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1033281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA794523OtherTUFTS HEALTH PLAN
MACAP03074OtherBCBS OF MASS
MA7165146OtherAETNA
MA04343088008OtherPACIFICARE BEHAVIORAL HEA
MA425748OtherHARVARD PILGRIM HEALTH CA
MA794523OtherTUFTS HEALTH PLAN