Provider Demographics
NPI:1063939155
Name:MCCALL, JOSEPHINE (LSW)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1300 VIRGINIA DR STE 110-C
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3221
Mailing Address - Country:US
Mailing Address - Phone:267-685-6382
Mailing Address - Fax:
Practice Address - Street 1:1300 VIRGINIA DR STE 110-C
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3221
Practice Address - Country:US
Practice Address - Phone:267-685-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0231141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical