Provider Demographics
NPI:1245430792
Name:MCGUIRE, MICHELLE KAYE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:KAYE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 W CRAIG RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2536
Mailing Address - Country:US
Mailing Address - Phone:702-901-5200
Mailing Address - Fax:702-901-5201
Practice Address - Street 1:5803 W CRAIG RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2536
Practice Address - Country:US
Practice Address - Phone:702-901-5200
Practice Address - Fax:702-901-5201
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0660103T00000X, 103T00000X
NVCP0031101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional