Provider Demographics
NPI:1063013985
Name:MCCALL, KYLE ALLAN (MA, LPC , LCDC, NCC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ALLAN
Last Name:MCCALL
Suffix:
Gender:M
Credentials:MA, LPC , LCDC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 JOE DIMAGGIO BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3928
Mailing Address - Country:US
Mailing Address - Phone:737-667-5680
Mailing Address - Fax:737-910-1362
Practice Address - Street 1:2851 JOE DIMAGGIO BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3928
Practice Address - Country:US
Practice Address - Phone:737-667-5680
Practice Address - Fax:737-910-1362
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15492101YA0400X
TX84481101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health