MEDICARE: CYNTHIA MCCALEB LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	62719	TX

General Provider Information

NPI Number	:	1285931097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MCCALEB LPC

Provider Business Mailing Address
First Line	:	819 WATER ST
Second Line	:	STE 300
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 CRYSTAL CITY HWY
Second Line	:
City	:	UVALDE
State	:	TX
Zip	:	78801-6124
Country	:	US
Telephone Number	:	830-278-4041
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2011
Last Update Date	:	02/15/2011

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