JODI SHAVER CALLAHAN (NPI# 1386915148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386915148 |
Entity Type | Individual |
Full Name | JODI SHAVER CALLAHAN |
Credential | LPC, LCAS |
Practice Address |
175 Kimel Park Dr Ste 100 Winston Salem NC 27103-6951 |
Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
Practice Telephone | 3367183550 |
Mailing Telephone | 3367183550 |
Mailing Fax Number | 3362776981 |
Enumeration Date | 2012-01-25 |
Last Update Date | 2020-10-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
3063 | NC | Behavioral Health & Social Service Providers |
N | 101YP2500X |
Counselor Specialization: Professional |
9585 | NC | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
284 Executive Park Drive, Suite 100, Concord, NC 280251894 | 7049391100 | 7049391173 |
Street Address |
175 KIMEL PARK DR STE 100 |
City | WINSTON SALEM |
State | NC |
Zip Code | 27103-6951 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740220748 | Cheri Jeannette Evans | Social Worker | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2006-06-07 |
1861033946 | Matthew Eric Millington | Physician Assistant | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103 | 2019-09-30 |
1932750833 | Alice I Barclay | Social Worker | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2019-09-23 |
1144880279 | Alison Bridges Russo | Social Worker | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2019-06-20 |
1508350349 | Forsyth Memorial Hospital Inc | Psychiatry & Neurology | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2018-06-15 |
1336650332 | Samuel Mcginnis | Counselor | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2017-10-17 |
1629444229 | Amanda Rose Wentz | Social Worker | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103 | 2015-08-18 |
1013242338 | Mindy Paris France | Counselor | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2009-10-04 |
1942485974 | Mari Allison Young | Counselor | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2008-01-09 |
1336167576 | Millicent Johnson Shadden | Social Worker | 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6951 | 2006-07-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
Find all providers in zip 27103 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215566385 | Sherrie Nicole Fogg | Counselor | 215 Braeburn Dr, Winston Salem, NC 27127-4691 | 2020-04-02 |
1831721968 | Olivia Henderson Smith | Counselor | 1 Medical Center Blvd 5th Floor Watlington Hall, Winston Salem, NC 27157-0001 | 2020-02-06 |
1578110805 | Elevation Counseling Services Pllc | Counselor | 1922 S Martin Luther King Jr Dr Ste 27, Winston Salem, NC 27107-1361 | 2019-08-21 |
1356900898 | Kendal Simeon Brown | Counselor | 4830 Tutelo Trl, Winston Salem, NC 27127-9419 | 2019-06-09 |
1497216667 | Larry Lamont Joe Jr. | Counselor | 1348 Westgate Center Dr Ste 204, Winston Salem, NC 27103-2984 | 2019-03-28 |
1558829994 | Esther Fredrica Dixon | Counselor | 326 N Spring St, Winston Salem, NC 27101-2722 | 2019-03-05 |
1609383736 | Stephanie Gimenez | Counselor | 163 Stratford Ct Ste 225, Winston Salem, NC 27103-1836 | 2018-01-10 |
1194239665 | Brandon Andre Jevon James | Counselor | 1922 S Martin Luther King Jr Dr Ste 225, Winston Salem, NC 27107-1361 | 2017-11-20 |
1417484304 | Jessica Lynn Vaughn | Counselor | 3640 Westgate Center Cir Ste A, Winston Salem, NC 27103 | 2017-05-22 |
1316472475 | Wendy Marshall | Counselor | 5078 Leeshire Way, Winston Salem, NC 27106-1870 | 2017-04-26 |
Find all providers in WINSTON SALEM |
City | WINSTON SALEM |
Zip Code | 27103 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.