Provider Demographics
NPI:1760211973
Name:CALLAGHAN, COURTNEY BAYLIE (MS)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BAYLIE
Last Name:CALLAGHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11604 SUMMIT ROCK CT
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-7573
Mailing Address - Country:US
Mailing Address - Phone:941-549-9050
Mailing Address - Fax:
Practice Address - Street 1:4837 SWIFT RD # 110-9
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5182
Practice Address - Country:US
Practice Address - Phone:614-500-3889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health