Individual
CHONTEL A JOHNSON MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
10380 SW VILLAGE CENTER DR STE 111, PORT SAINT LUCIE, FL 34987-1931
(954) 608-9093
Mailing address
10380 SW VILLAGE CENTER DR STE 111, PORT SAINT LUCIE, FL 34987-1931
(954) 608-9093
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070812700
—
FL
Enumeration date
09/07/2016
Last updated
05/14/2024
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