Provider Demographics
NPI:1922481282
Name:MCCALL, JESSICA (MS, LMFTA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8029 CORPORATE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4547
Mailing Address - Country:US
Mailing Address - Phone:980-237-3880
Mailing Address - Fax:
Practice Address - Street 1:8029 CORPORATE CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4547
Practice Address - Country:US
Practice Address - Phone:980-237-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10074A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist