Individual
ELLEN FITZGERALD-MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
(401) 861-8696
Mailing address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
(401) 861-8696
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02290
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
Enumeration date
03/11/2010
Last updated
02/19/2013
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