Individual ProviderKerry J CallahanSocial WorkerBehavioral Health & Social Service ProvidersPractice Address174 Grand Ave, Englewood, NJ 07631-3585(201) 370-2289PECOS EnrollmentThis provider is enrolled in PECOS as KERRY CALLAHAN.Based on the most recent information from CMS, provider Kerry J Callahan is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1942522792Provider TypeIndividualFull NameCallahan, Kerry JCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date2/22/2010Last Updated2/22/2012Contact InformationPractice LocationPractice Address174 Grand Ave, Englewood, NJ 07631-3585Phone(201) 370-2289FaxUnlisted FaxMailing LocationMailing Address174 Grand Ave, Englewood, NJ 07631-3585Phone(201) 370-2289FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense44SC05382600New Jersey