Provider Demographics
NPI:1932560497
Name:MCCALEB, KATHY (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:MCCALEB
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 1:2603 E BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-4008
Mailing Address - Country:US
Mailing Address - Phone:714-348-1210
Mailing Address - Fax:
Practice Address - Street 1:2603 E BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4008
Practice Address - Country:US
Practice Address - Phone:714-348-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS110951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical