Provider Demographics
NPI:1083351167
Name:MCCALL, HEATH AUSTIN
Entity Type:Individual
Prefix:
First Name:HEATH
Middle Name:AUSTIN
Last Name:MCCALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 JAMESTOWN RD SE
Mailing Address - Street 2:
Mailing Address - City:CROOKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43731-9581
Mailing Address - Country:US
Mailing Address - Phone:740-221-4237
Mailing Address - Fax:
Practice Address - Street 1:825 DENNISON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1315
Practice Address - Country:US
Practice Address - Phone:614-291-4691
Practice Address - Fax:614-291-6323
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180807101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)