Provider Demographics
NPI:1821987298
Name:CALLAHAN, MICHAELA M (LMT)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:M
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 HUNNEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-3507
Mailing Address - Country:US
Mailing Address - Phone:207-650-7926
Mailing Address - Fax:
Practice Address - Street 1:192 ELM ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-3315
Practice Address - Country:US
Practice Address - Phone:207-650-7926
Practice Address - Fax:207-650-7926
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT8012225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist