Provider Demographics
NPI:1598852212
Name:CALLAHAN, KATHERINE LEONARD (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LEONARD
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MRS
Other - First Name:KATHY
Other - Middle Name:LEONARD
Other - Last Name:CALLAHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:29315 ERICKSON DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8651
Mailing Address - Country:US
Mailing Address - Phone:410-690-8181
Mailing Address - Fax:410-690-8185
Practice Address - Street 1:8614 OCEAN GTWY
Practice Address - Street 2:STE 4
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7217
Practice Address - Country:US
Practice Address - Phone:410-690-8181
Practice Address - Fax:410-690-8181
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
517251OtherUNITED HEALTH CARE MAMSI
517251OtherUHC MAMSI GROUP
MD609550002Medicaid
MDLM49EAOtherCAREFIRST BCBS GROUP
MD259147000OtherMAGELLAN GROUP
MD522555502OtherCAREFIRST BCBS PIN
724337OtherNCPPO PIN
003953OtherVALUE OPTIONS
100062229001OtherAMERICAN PSYCH SYSTEM
6296784OtherUNITED BEHAVIORAL HEALTH
DCR968OtherCAREFIRST FEDERAL GROUP
DC0012OtherCAREFIRST FEDERAL PIN
MD461837000OtherMAGELLAN PIN
MD522555502OtherCAREFIRST BCBS PIN
100062229001OtherAMERICAN PSYCH SYSTEM