Provider Demographics
NPI:1386787760
Name:CALLAHAN, ELIZABETH WILLE (BSW, CCM)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WILLE
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:BSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 540
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-6438
Mailing Address - Country:US
Mailing Address - Phone:828-773-7125
Mailing Address - Fax:
Practice Address - Street 1:207 SUNBURST LN
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6438
Practice Address - Country:US
Practice Address - Phone:828-264-9812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker