Provider Demographics
NPI:1336687516
Name:MCCALL, CODY JAMES (LMHC)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:JAMES
Last Name:MCCALL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 3RD AVE STE 229
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1194
Mailing Address - Country:US
Mailing Address - Phone:509-540-0248
Mailing Address - Fax:
Practice Address - Street 1:555 ANDOVER PARK W STE 200
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3379
Practice Address - Country:US
Practice Address - Phone:206-257-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2023-07-05
Deactivation Date:2019-11-09
Deactivation Code:
Reactivation Date:2020-01-13
Provider Licenses
StateLicense IDTaxonomies
WALH61130728101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health