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Individual

DALE CALVIN MCCALLISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCA

Contact information

Practice address
221 NEW BRIDGE ST, JACKSONVILLE, NC 28540-4736
(910) 378-7676
Mailing address
815 LITTLEJOHN AVE, JACKSONVILLE, NC 28546-5517
(910) 346-8504

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A14157
NC
101YS0200X
School Counselor
980729
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A14157
NC BOARD OF LICENSED PROFESSIONAL COUNSELORS
NC
Enumeration date
10/16/2019
Last updated
10/16/2019
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