Provider Demographics
NPI:1598423972
Name:MCCALL, TIANA (LCSW)
Entity Type:Individual
Prefix:
First Name:TIANA
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15155 S ROSE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-3655
Mailing Address - Country:US
Mailing Address - Phone:435-619-9570
Mailing Address - Fax:
Practice Address - Street 1:15155 S ROSE VIEW LN
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-3655
Practice Address - Country:US
Practice Address - Phone:435-619-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10148217-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical