Provider Demographics
NPI:1538253547
Name:CALLAGHAN-WALSH, HEATHER J M (LCSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:J M
Last Name:CALLAGHAN-WALSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:J M
Other - Last Name:CALLAGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:1204 HOLLY LANE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:610-892-3800
Mailing Address - Fax:484-468-1412
Practice Address - Street 1:1204 HOLLY LANE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342
Practice Address - Country:US
Practice Address - Phone:610-892-3800
Practice Address - Fax:484-468-1412
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0132901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical