Individual
MS. CANDACE ALEXIS MCCALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
2440 HUNTER AVE, BRONX, NY 10475-5646
(917) 693-8316
Mailing address
2440 HUNTER AVE APT 26F, BRONX, NY 10475-5658
(917) 693-8316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
079742
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04686848
—
NY
01
—
4741862
EMBLEM HEALTH/GHI PROVIDER
NY
Enumeration date
11/18/2011
Last updated
08/10/2022
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