Provider Demographics
NPI:1952005621
Name:CALLAHAN, SEAN M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:M
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5629 6TH AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-7254
Mailing Address - Country:US
Mailing Address - Phone:630-802-9131
Mailing Address - Fax:
Practice Address - Street 1:4365 LAWN AVE STE 8
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1494
Practice Address - Country:US
Practice Address - Phone:773-888-2602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0253871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical