Provider Demographics
NPI:1053092569
Name:MCCALL, KIMBERLY PAIGE (LMSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:PAIGE
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:PAIGE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1815 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-336-1339
Practice Address - Street 1:1815 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72405-7870
Practice Address - Country:US
Practice Address - Phone:870-933-6886
Practice Address - Fax:870-336-1339
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker