Provider Demographics
NPI:1215633953
Name:CALLAHAN, JOSEPH T (RBT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6533 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-2229
Mailing Address - Country:US
Mailing Address - Phone:727-534-3234
Mailing Address - Fax:727-255-5151
Practice Address - Street 1:6533 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-2229
Practice Address - Country:US
Practice Address - Phone:727-534-3234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-252430106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician