Kim Callahan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094723 Issued in NY

Practice address

71 Elizabeth Dr
Bethpage, NY 11714-6434

Phone

(516) 353-3537

NPI assigned

Sep 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• KC LCSW PC

  dba Dandelion Wellness Counseling

  • Clinical Social Worker
  • West Islip, NY
  • NPI 1356109938
  NPD Authorized official

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1982254926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ELIZABETH DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117146434",
            "telephone_number": "516-353-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 ELIZABETH DR",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117146434",
            "telephone_number": "516-353-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jewelle Jordyn Burton, M.D.
• Bussani Mobility Team Nyc, LLC
• Jessica A. Cabeza, LMSW
• Lynda G Calamia, RN
• Bridgette S. Calderon, MSN, FNP
• Shannon Camarda
• Michael Anthony Camp, DPT
• Elayne Candiotte
• Francesco J Caputo, D.C.
• Lizabeth Carino, LMHC

• Clinical Social Worker in Bethpage, NY
• Providers in Bethpage, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.