Provider Demographics
NPI:1528297066
Name:MCCALL, MIRIAM WALZ (LPCC)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:WALZ
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-1205
Mailing Address - Country:US
Mailing Address - Phone:330-343-7400
Mailing Address - Fax:330-343-7414
Practice Address - Street 1:1347 4TH ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-1205
Practice Address - Country:US
Practice Address - Phone:330-343-7400
Practice Address - Fax:330-343-7414
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE-0003023OtherSTATE OF OH COUNSELOR & SOCIAL WORKER BOARD