Provider Demographics
NPI:1720854383
Name:MCCALL-KEMP, SONYA MAUDEEN (LSW)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:MAUDEEN
Last Name:MCCALL-KEMP
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5931 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3210
Mailing Address - Country:US
Mailing Address - Phone:267-342-2188
Mailing Address - Fax:
Practice Address - Street 1:5931 N 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19141-3210
Practice Address - Country:US
Practice Address - Phone:267-342-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140266104100000X
MD30317104100000X
DCSW140266104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker