Carol Mccallister | Santa Monica, CA • PECOS Search

Carol Mccallister

Marriage & Family Therapist

Behavioral Health & Social Service Providers

2730 Wilshire Blvd Ste 660, Santa Monica, CA 90403-4746

PECOS Enrollment

Based on the most recent information from CMS, provider Carol Mccallister does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1679102586
Provider Type
Individual
Full Name
Mccallister, Carol
Credential
LMFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/2/2020
Last Updated
4/2/2020

Contact Information

Practice Location

2730 Wilshire Blvd Ste 660, Santa Monica, CA 90403-4746

Unlisted Fax

Mailing Location

759 Haverford Ave, Pacific Palisades, CA 90272-4313

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 53042 California