Kelly Lynn Callahan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C015249 Issued in NC

Practice address

10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513

Phone

(704) 360-3637

NPI assigned

Oct 19, 2022

Last updated

Oct 25, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Wellness Solutions, PLLC

  dba LifeStance Health

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871
  Medicare reassignment Care Compare group
• Asheli Thompson

  dba Integrative Wellness Solutions

  • Community/Behavioral Health Agency
  • Mooresville, NC
  • NPI 1073955621
  NPD

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1629794755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 ASHWELL OAKS LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051213",
            "telephone_number": "904-614-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 HARRIS OAK BLVD STE L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697513",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calissa's Counseling Services, LLC
• Madison Call
• Callahan Coaching & Consulting, LLC
• Catherine Brittain Callahan, MD
• Darci Callahan, LMFT
• Linda Callahan, COTA
• Natasha Callahan
• Sarah Callahan, PT, DPT
• Callaway Associates (Pro Med Minor Emergency Centers)
• Callaway Associates (Pro Med Minor Emergency Centers)

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.