Vincent Lawrence Calloway, MSS, LCSW, CEAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019505 Issued in PA

Practice address

1989 N 63Rd St Ste 200
Philadelphia, PA 19151-2607

Phone

(215) 878-1258

Fax

(215) 878-8998

NPI assigned

Jul 18, 2018

Reactivated

Feb 27, 2020

Sex

Male

Sole proprietor

Yes

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

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.

• Randolph Walters & Associates, LLC

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1700124666
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1174009427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 N. 63RD ST., SUITE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 N 63RD ST STE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512607",
            "telephone_number": "215-878-1258",
            "fax_number": "215-878-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "VINCENT",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "MSS, LCSW, CEAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "deactivation_date": "2020-02-25",
        "reactivation_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Callejas, D.M.D.
• Keith Don Calligaro, MD
• Calloway Counseling LLC
• Courtney Calloway, LPC
• Michael Calloway, BA
• Martin Calotti, MD
• Nicole Caltagirone
• Stephen James Calvarese, LCSW
• Anne Calvaresi, CRNP
• Calvary Home Care Service LLC

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.