Provider Demographics
NPI:1932646031
Name:MCCALL, COLLEEN W (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:W
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7272 WURZBACH RD
Mailing Address - Street 2:SUITE 706
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4801
Mailing Address - Country:US
Mailing Address - Phone:210-615-3483
Mailing Address - Fax:210-593-9863
Practice Address - Street 1:7272 WURZBACH RD
Practice Address - Street 2:SUITE 706
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4801
Practice Address - Country:US
Practice Address - Phone:210-615-3483
Practice Address - Fax:210-593-9863
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01743OtherLICENSE
TX01743OtherLICENSE