Provider Demographics
NPI:1801272612
Name:MCCALL, KYLE D (MED, QMHP-C, LPC)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:D
Last Name:MCCALL
Suffix:
Gender:M
Credentials:MED, QMHP-C, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 HANOVER GREEN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1705
Mailing Address - Country:US
Mailing Address - Phone:804-781-4418
Mailing Address - Fax:804-212-0981
Practice Address - Street 1:7308 HANOVER GREEN DR
Practice Address - Street 2:300
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1793
Practice Address - Country:US
Practice Address - Phone:804-781-4418
Practice Address - Fax:804-212-0981
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor