Provider Demographics
NPI:1508551060
Name:MCCALL, EMILY ANNE (LSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CYNWYD DR
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-2223
Mailing Address - Country:US
Mailing Address - Phone:609-313-5752
Mailing Address - Fax:
Practice Address - Street 1:4 E JIMMIE LEEDS RD STE 8
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4465
Practice Address - Country:US
Practice Address - Phone:609-839-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06866300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker