Provider Demographics
NPI:1811123094
Name:CALLAHAN, ANNA SUZETTE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:SUZETTE
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1002 ANNA KNAPP EXT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5421
Mailing Address - Country:US
Mailing Address - Phone:843-853-7030
Mailing Address - Fax:843-884-5353
Practice Address - Street 1:1002 ANNA KNAPP EXT
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5421
Practice Address - Country:US
Practice Address - Phone:843-853-7030
Practice Address - Fax:843-884-5353
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health