Provider Demographics
NPI:1396291290
Name:MCCALL, THOMAS W JR (LCSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:MCCALL
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 GARRISON RD
Mailing Address - Street 2:APT 2113
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-2678
Mailing Address - Country:US
Mailing Address - Phone:940-535-4286
Mailing Address - Fax:
Practice Address - Street 1:3150 GARRISON RD
Practice Address - Street 2:APT 2113
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-2678
Practice Address - Country:US
Practice Address - Phone:940-535-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical