Provider Demographics
NPI:1710327028
Name:MCCALL, CAROL (LGSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2446
Mailing Address - Country:US
Mailing Address - Phone:410-228-3929
Mailing Address - Fax:410-228-3810
Practice Address - Street 1:2013 NORTHWOOD DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7882
Practice Address - Country:US
Practice Address - Phone:410-334-6687
Practice Address - Fax:410-334-6700
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18656104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker