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NPI Code Detail

MEDICARE: MS. ROSEMARY MCCALLUM-HERBERT LMSW, CAAC

MEDICARE: MS. ROSEMARY MCCALLUM-HERBERT LMSW, CAAC
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
11041C0700XClinical Social Worker6801046841MI

General Provider Information

NPI Number : 1801970850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSEMARY MCCALLUM-HERBERT LMSW, CAAC
Provider Business Mailing Address
First Line : 9249 W LAKE CITY RD
Second Line :
City : HOUGHTON LAKE
State : MI
Zip : 48629-9602
Country : US
Telephone Number : 989-422-5122
Fax Number :
Provider Business Practice Location Address
First Line : 439 S ROSS ST
Second Line :
City : BEAVERTON
State : MI
Zip : 48612-9101
Country : US
Telephone Number : 989-246-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 12/08/2014

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