Provider Demographics
NPI:1174122485
Name:CALLOWAY, SHARLA (LCSW)
Entity type:Individual
Prefix:
First Name:SHARLA
Middle Name:
Last Name:CALLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E GOVERNMENT ST STE B-2
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6507
Mailing Address - Country:US
Mailing Address - Phone:850-220-2014
Mailing Address - Fax:
Practice Address - Street 1:310 E GOVERNMENT ST STE B-2
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6507
Practice Address - Country:US
Practice Address - Phone:502-202-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
FLSW177101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171400000XOther Service ProvidersHealth & Wellness Coach