Individual provider Active NPI

Kelly Callahan, LISW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1417990656
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-0008933 Issued in OH
Practice address
4624 Sawmill Rd
Columbus, OH 43220-2247
Phone
(614) 459-4490
Fax
(614) 457-3656
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I-0008933 OH Primary

Addresses

Primary practice location

4624 Sawmill Rd
Columbus, OH 43220-2247

Mailing address

4624 Sawmill Rd
Columbus, OH 43220-2247
Phone (614) 459-4490

Other identifiers 1

IdentifierTypeStateIssuer
SW28413OtherOHMEDICARE PIN TYPE UNSPECIFIED

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
I-0008933OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Cognitive Behavioral Therapy of Greater Columbus Inc Social Worker Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1417990656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-459-4490",
            "fax_number": "614-457-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 SAWMILL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202247",
            "telephone_number": "614-459-4490",
            "fax_number": "614-457-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KELLY",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-0008933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN TYPE UNSPECIFIED",
            "identifier": "SW28413",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.