Provider Demographics
NPI:1245973072
Name:MCCALL, HEATHER KARINNE (MSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KARINNE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:KARINNE
Other - Last Name:BRAY-BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 W FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4145
Mailing Address - Country:US
Mailing Address - Phone:704-865-3525
Mailing Address - Fax:
Practice Address - Street 1:175 W FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4145
Practice Address - Country:US
Practice Address - Phone:704-865-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical