Provider Demographics
NPI:1336247865
Name:MCCALL-GARRETT, CARLA MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:MARIE
Last Name:MCCALL-GARRETT
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 1:300 WESTEND LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4824
Mailing Address - Country:US
Mailing Address - Phone:865-330-9611
Mailing Address - Fax:865-330-9612
Practice Address - Street 1:300 WESTEND LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-330-9611
Practice Address - Fax:865-330-9611
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000031901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3074966OtherBLUECROSSBLUESHIELD
TN3923571Medicare ID - Type Unspecified