Provider Demographics
NPI:1104453794
Name:MCCARVILLE, JACALYN (LMHC)
Entity type:Individual
Prefix:
First Name:JACALYN
Middle Name:
Last Name:MCCARVILLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 N DODGE ST STE A
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-6121
Mailing Address - Country:US
Mailing Address - Phone:515-570-4980
Mailing Address - Fax:
Practice Address - Street 1:913 BALL ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-1505
Practice Address - Country:US
Practice Address - Phone:515-570-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health