Provider Demographics
NPI:1730764903
Name:CALLAHAN, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3164
Mailing Address - Country:US
Mailing Address - Phone:207-707-5177
Mailing Address - Fax:207-494-8471
Practice Address - Street 1:48 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3164
Practice Address - Country:US
Practice Address - Phone:207-707-5177
Practice Address - Fax:207-494-8471
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC221201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical