Provider Demographics
NPI:1780459446
Name:CALLAWAY, SCHYLER J
Entity type:Individual
Prefix:
First Name:SCHYLER
Middle Name:J
Last Name:CALLAWAY
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 1:1750 SHILOH RD NW APT 641
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6480
Mailing Address - Country:US
Mailing Address - Phone:678-751-3413
Mailing Address - Fax:
Practice Address - Street 1:1750 SHILOH RD NW APT 641
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6480
Practice Address - Country:US
Practice Address - Phone:678-751-3413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009039104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker