Active NPI
Ryan P McCallum, LCSW
- Clinical Social Worker
- Jber, AK
National Provider Identifier
1831880251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 110324
- Practice address
- 786 D St
Jber, AK 99505-1023 - Phone
- (907) 384-0405
- NPI assigned
- May 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 110324 | TX | Primary |
| Clinical Social Worker | 1041C0700X | 13382587-3501 | UT |
Addresses
Primary practice location
786 D St
Jber, AK 99505-1023
Mailing address
4076 Neely Road
Fort Wainwright, AK 99703
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
| License | State | Type | Specialty |
|---|---|---|---|
| 110324 | TX | MD | Clinical Social Worker |
| 13382587-3501 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786752000000",
"number": "1831880251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4076 NEELY ROAD",
"city": "FORT WAINWRIGHT",
"state": "AK",
"postal_code": "99703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "786 D ST",
"city": "JBER",
"state": "AK",
"postal_code": "995051023",
"telephone_number": "907-384-0405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALLUM",
"first_name": "RYAN",
"middle_name": "P",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-17",
"last_updated": "2026-08-15",
"certification_date": "2026-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "110324",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "13382587-3501",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jber, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.