Provider Demographics
NPI:1386770436
Name:CALLAN, NAN (LMHC)
Entity type:Individual
Prefix:MS
First Name:NAN
Middle Name:
Last Name:CALLAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HOMEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1508
Mailing Address - Country:US
Mailing Address - Phone:863-294-8416
Mailing Address - Fax:863-293-4378
Practice Address - Street 1:950 1ST ST S
Practice Address - Street 2:SUITE 205
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3665
Practice Address - Country:US
Practice Address - Phone:863-299-8400
Practice Address - Fax:863-293-4378
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 1910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health