| Kelly M Mccall Lcsw, Pllc | |
|
2478 George Urban Blvd Depew NY 14043-2010 | |
| (716) 440-7165 | |
| (716) 901-7407 |
| Full Name | Kelly M Mccall Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2478 George Urban Blvd, Depew, New York |
| Authorized Official Name and Position | Kelly M Mccall (OWNER) |
| Authorized Official Contact | 7164407165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly M Mccall Lcsw, Pllc 2478 George Urban Blvd Depew NY 14043 Ph: (716) 440-7165 | Kelly M Mccall Lcsw, Pllc 2478 George Urban Blvd Depew NY 14043-2010 Ph: (716) 440-7165 |
| NPI Number | 1396292413 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 09/07/2016 |
| Medicare PECOS PAC ID | 4981037355 |
|---|---|
| Medicare Enrollment ID | O20191126001831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396292413 | NPI | - | NPPES |
| 1770731572 | Other | NY | FIDELIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly Marie Mccall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770731572 PECOS PAC ID: 9335571595 Enrollment ID: I20191111000196 |
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