Provider Demographics
NPI:1285232892
Name:MCKAY, DEVAN
Entity Type:Individual
Prefix:
First Name:DEVAN
Middle Name:
Last Name:MCKAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WASHINGTON ST STE 206
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-5538
Mailing Address - Country:US
Mailing Address - Phone:413-739-5572
Mailing Address - Fax:
Practice Address - Street 1:1100 WASHINGTON ST STE 206
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5538
Practice Address - Country:US
Practice Address - Phone:413-739-5572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional