Kevin P Callaghan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13114 Issued in MN

Practice address

1515 E 66TH St
Richfield, MN 55423-2648

Phone

(763) 545-6558

NPI assigned

Dec 12, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Damascus Way

  • Recovery Care Clinic/Center
  • Richfield, MN
  • NPI 1326822529
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1164290938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E 66TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E 66TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232648",
            "telephone_number": "763-545-6558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2118 Campus Dr SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046492",
            "country_code": "US",
            "telephone_number": "763-545-6558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Marschall Rd",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553793337",
            "country_code": "US",
            "telephone_number": "763-545-6558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAGHAN",
        "first_name": "KEVIN",
        "middle_name": "P",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Buchmayer
• Dana Bullock
• Alison Ann Burris, M.S.
• Sarah Elizabeth Burton
• Mykuhl Cade
• Katherineanne Nguyen Campbell
• Capernaum Pediatric Therapy, Inc.
• Riley Capizzi, PHD
• Carelink Direct LLC
• Marnie K Carlson, MSW, LICSW

• Clinical Social Worker in Richfield, MN
• Providers in Richfield, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.