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Individual

MR. JERRY WILLIAM MACCAULEY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
411 CEDAR RD, CHESAPEAKE, VA 23322-5566
(757) 548-8848
(757) 549-1347
Mailing address
411 CEDAR RD, CHESAPEAKE, VA 23322-5566
(757) 548-8848
(757) 549-1347

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002572
VA

Other

Enumeration date
07/06/2005
Last updated
07/08/2007
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