Provider Demographics
NPI:1699150334
Name:CALLARMAN, PHOENIX (MA, LMHC)
Entity type:Individual
Prefix:
First Name:PHOENIX
Middle Name:
Last Name:CALLARMAN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9404 TOUCAN PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3612
Mailing Address - Country:US
Mailing Address - Phone:505-385-3922
Mailing Address - Fax:
Practice Address - Street 1:9404 TOUCAN PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3612
Practice Address - Country:US
Practice Address - Phone:505-385-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health