MEDICARE: JEREMY MCCALL, LMSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1518653500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEREMY MCCALL, LMSW

Provider Business Mailing Address
First Line	:	2675 LAPEER RD
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-1926
Country	:	US
Telephone Number	:	248-795-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	2675 LAPEER RD
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-1926
Country	:	US
Telephone Number	:	248-795-5299
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH CLINICIAN
Name	:	MR. JEREMY MCCALL
Credential	:	LMSW
Telephone Number	:	248-795-5299

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	04/13/2023

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