Provider Demographics
NPI:1629550207
Name:MCCALE, DEBRA ANN (CDCA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:MCCALE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:KUTCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA
Mailing Address - Street 1:NEIL KENNEDY 2151 RUSH BLVD.
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507
Mailing Address - Country:US
Mailing Address - Phone:330-744-1181
Mailing Address - Fax:
Practice Address - Street 1:2151 RUSH BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1535
Practice Address - Country:US
Practice Address - Phone:330-744-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.167377101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)