Maureen M Callahan, LCSW

Individual provider Active NPI Clinical Social Worker · Roscoe, IL

NPI 1679046809 · NPPES record last updated Nov 7, 2023

Key facts

NPI
1679046809
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149023544 (IL)
Practice address
11447 2ND St Ste 9B
Roscoe, IL 61073-9522
Phone
(815) 601-4673
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
149023544ILMDClinical Social Worker
9021-123WIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9021-123 WI
Clinical Social Worker 1041C0700X 149023544 IL Yes

Addresses

Primary practice location

11447 2ND St Ste 9B
Roscoe, IL 61073-9522

Mailing address

11447 2ND St Ste 9Aandb
Roscoe, IL 61073-9522
Phone (815) 601-4673

Other providers in Roscoe, IL

All providers in Roscoe, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.