Provider Demographics
NPI:1851163851
Name:MCCALL, COURTNEY ELISE (MSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELISE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 FIVE SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4915
Mailing Address - Country:US
Mailing Address - Phone:804-337-2647
Mailing Address - Fax:
Practice Address - Street 1:2025 E MAIN ST STE 216
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7073
Practice Address - Country:US
Practice Address - Phone:804-644-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical