Provider Demographics
NPI:1851328116
Name:MCCALL, CYNTHIA H (LSW, LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:H
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7310
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25356-0310
Mailing Address - Country:US
Mailing Address - Phone:304-776-7606
Mailing Address - Fax:304-776-7636
Practice Address - Street 1:100 PEYTON WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314
Practice Address - Country:US
Practice Address - Phone:304-720-8466
Practice Address - Fax:304-720-8463
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV412101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV412OtherPROFESSIONAL COUNSELOR
WVAP00454741OtherSW LICENSE