Provider Demographics
NPI:1225858988
Name:MACALL, MERCEDES M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:M
Last Name:MACALL
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 1:1245 VIA CONTESSA
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-7365
Mailing Address - Country:US
Mailing Address - Phone:626-806-9416
Mailing Address - Fax:
Practice Address - Street 1:3697 LA MIRADA DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2312
Practice Address - Country:US
Practice Address - Phone:769-290-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1255521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical