Provider Demographics
NPI:1992337539
Name:MCCALEB, BRITTANY (MAC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MCCALEB
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 BORDEAU WAY
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-5894
Mailing Address - Country:US
Mailing Address - Phone:770-733-7346
Mailing Address - Fax:
Practice Address - Street 1:12461 VETERANS MEMORIAL HWY STE 575
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2025
Practice Address - Country:US
Practice Address - Phone:770-733-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1314101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty