Provider Demographics
NPI:1154696052
Name:ZUPON, MCCALL ANN (PC)
Entity type:Individual
Prefix:
First Name:MCCALL
Middle Name:ANN
Last Name:ZUPON
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WHITETAIL LN
Mailing Address - Street 2:
Mailing Address - City:BENTLEYVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3600
Mailing Address - Country:US
Mailing Address - Phone:440-247-8585
Mailing Address - Fax:
Practice Address - Street 1:5000 ROCKSIDE RD.
Practice Address - Street 2:SUITE 310
Practice Address - City:INDEPENDENEC
Practice Address - State:OH
Practice Address - Zip Code:44022
Practice Address - Country:US
Practice Address - Phone:216-901-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1200100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional