Individual provider Active NPI

Vickie McCallister, MSW LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1700898335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34000781A Issued in IN
Practice address
60 S Stockwell Road
Evansville, IN 47714
Phone
(812) 476-5437
Fax
(812) 422-7558
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34000781A IN Primary

Addresses

Primary practice location

60 S Stockwell Road
Evansville, IN 47714

Mailing address

415 Mulberry Street
Evansville, IN 47713-1298
Phone (812) 423-7791

Other identifiers 1

IdentifierTypeStateIssuer
34000781AOtherINLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34000781AINMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700898335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131298",
            "telephone_number": "812-423-7791",
            "fax_number": "812-422-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S STOCKWELL ROAD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-476-5437",
            "fax_number": "812-422-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLISTER",
        "first_name": "VICKIE",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000781A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "34000781A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.