Provider Demographics
NPI:1477869386
Name:SCOTT MCCALEB COUNSELING SERVICE
Entity Type:Organization
Organization Name:SCOTT MCCALEB COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MCCALEB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-244-2772
Mailing Address - Street 1:307 E NORTHERN LIGHTS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2701
Mailing Address - Country:US
Mailing Address - Phone:907-244-2772
Mailing Address - Fax:
Practice Address - Street 1:7516 EASTBROOK CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3568
Practice Address - Country:US
Practice Address - Phone:907-929-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1000261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health