Provider Demographics
NPI:1174147946
Name:CALLISON, CLAUDIA ELISE (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:ELISE
Last Name:CALLISON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:ELISE
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5262
Mailing Address - Country:US
Mailing Address - Phone:858-610-9788
Mailing Address - Fax:
Practice Address - Street 1:103 BRYAN DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5262
Practice Address - Country:US
Practice Address - Phone:858-610-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-18786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health