=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073427670
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TCAL CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2026
-----------------------------------------------------
Last Update Date | 09/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2110 OLD CUBA RD
-----------------------------------------------------
City | EUBANK
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42567-8793
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-699-4634
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2110 OLD CUBA RD
-----------------------------------------------------
City | EUBANK
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42567-8793
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TINTISHA CLANTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 502-699-4634
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------