Individual provider Active NPI

Michelle Callahan, LSCSW, LCSW

  • Clinical Social Worker
  • Liberty, MO
National Provider Identifier
1417226945
Registry record updated Feb 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3614 Issued in KS
Practice address
40A Westwoods Dr
Liberty, MO 64068-3519
Phone
(816) 781-2349
Fax
(816) 792-8232
NPI assigned
Dec 29, 2011
Last updated
Feb 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2006008200 MO
Clinical Social Worker 1041C0700X 3614 KS Primary

Addresses

Primary practice location

40A Westwoods Dr
Liberty, MO 64068-3519

Mailing address

11027 Northridge Dr
Kansas City, KS 66109-4905
Phone (913) 961-1719

Other identifiers 1

IdentifierTypeStateIssuer
200866370AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3614KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Choices for Life, LLC Past Accepting new patients
N Haney & Associates LLC Clinical Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359849600000",
    "number": "1417226945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11027 NORTHRIDGE DR",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661094905",
            "telephone_number": "913-961-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40A WESTWOODS DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683519",
            "telephone_number": "816-781-2349",
            "fax_number": "816-792-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MICHELLE",
        "credential": "LSCSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2013-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006008200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200866370A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2013; 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.