Provider Demographics
NPI:1780196337
Name:MCCALL, ADAM MOORE (MSW, QIDP, QMHP-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MOORE
Last Name:MCCALL
Suffix:
Gender:M
Credentials:MSW, QIDP, QMHP-C
Other - Prefix:
Other - First Name:ADAM
Other - Middle Name:JAMES
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, QIDP, QMHP-C
Mailing Address - Street 1:7300 HANOVER GREEN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1705
Mailing Address - Country:US
Mailing Address - Phone:804-781-4418
Mailing Address - Fax:804-212-0981
Practice Address - Street 1:7300 HANOVER GREEN DR STE 100
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1705
Practice Address - Country:US
Practice Address - Phone:804-781-4418
Practice Address - Fax:804-212-0981
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker