Provider Demographics
NPI:1427788991
Name:PODRAZA, CALLIE MARTELL (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:MARTELL
Last Name:PODRAZA
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 BARRETT DR STE 310
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7220
Mailing Address - Country:US
Mailing Address - Phone:704-309-3747
Mailing Address - Fax:
Practice Address - Street 1:3824 BARRETT DR STE 310
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7220
Practice Address - Country:US
Practice Address - Phone:704-337-5052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health