Callan Lichtenauer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104-557522 Issued in VA

Practice address

9649 Fairfax Blvd
Fairfax, VA 22031-2321

Phone

(571) 406-4102

NPI assigned

Sep 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Callan Dill Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1447867353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9649 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312321",
            "telephone_number": "571-406-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9649 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312321",
            "telephone_number": "571-406-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENAUER",
        "first_name": "CALLAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLAN",
            "last_name": "DILL",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Russell Clark Libby, M.D.
• Carolyn Marie Libert, MSPT
• Liberty Home Health Care, LLC
• Ariella Libicki
• Damon J Licari, PA
• Evan Lichtenauer, DC
• Elissa Lichtman, OTD, OTR/L
• Kelly Robin Lieber, LCSW LCSWC LGSW
• Michael Charles Lieberman, LPC
• Ronald Lieberman, LCSW

• Chiropractor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.