Provider Demographics
NPI:1942847140
Name:MCFALL, OCTAVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:OCTAVIA
Middle Name:
Last Name:MCFALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OCTAVIA
Other - Middle Name:
Other - Last Name:PENDLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 361327
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-1327
Mailing Address - Country:US
Mailing Address - Phone:317-253-7387
Mailing Address - Fax:317-253-7388
Practice Address - Street 1:12021 NORTHFACE DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-9412
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:317-253-7388
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical