Provider Demographics
NPI:1326169970
Name:MCCREIGHT, JACQUELINE G (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:G
Last Name:MCCREIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 301225
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38130-1225
Mailing Address - Country:US
Mailing Address - Phone:901-652-8391
Mailing Address - Fax:901-652-8391
Practice Address - Street 1:1835 UNION AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3921
Practice Address - Country:US
Practice Address - Phone:901-652-8391
Practice Address - Fax:901-652-8391
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2612101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional