Provider Demographics
NPI:1063058196
Name:PRICE, CALLIE (LCSW)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5925
Mailing Address - Country:US
Mailing Address - Phone:540-370-6983
Mailing Address - Fax:540-427-7912
Practice Address - Street 1:308 WOLFE ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5925
Practice Address - Country:US
Practice Address - Phone:540-370-6983
Practice Address - Fax:540-427-7912
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-06063991041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool