MEDICARE: CHELBY MCCALL

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	101Y00000X	Counselor	PC-0012061	DE

General Provider Information

NPI Number	:	1669301982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELBY MCCALL

Provider Business Mailing Address
First Line	:	203 W DELAWARE AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-1205
Country	:	US
Telephone Number	:	443-566-0623
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 W DELAWARE AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-1205
Country	:	US
Telephone Number	:	443-566-0623
Fax Number	:

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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