Individual ProviderDominique CallowaySocial WorkerBehavioral Health & Social Service ProvidersPractice Address5655 S Yosemite St, Greenwood Village, CO 80111-3218(720) 213-5955PECOS EnrollmentBased on the most recent information from CMS, provider Dominique Calloway is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:02 AM.Profile DetailsProvider ID1871362475Provider TypeIndividualFull NameCalloway, DominiqueCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date12/22/2023Last Updated12/22/2023Contact InformationPractice LocationPractice Address5655 S Yosemite St, Greenwood Village, CO 80111-3218Phone(720) 213-5955FaxUnlisted FaxMailing LocationMailing Address5655 S Yosemite St, Greenwood Village, CO 80111-3218Phone(720) 213-5955FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense09930034Colorado