Provider Demographics
NPI:1326404492
Name:MCCAIN, CHAD A (LMFT)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:A
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 SUMMERCREEK DR APT 45
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-7759
Mailing Address - Country:US
Mailing Address - Phone:949-302-2874
Mailing Address - Fax:
Practice Address - Street 1:2319 SUMMERCREEK DR APT 45
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-7759
Practice Address - Country:US
Practice Address - Phone:949-302-2874
Practice Address - Fax:707-703-5794
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77045106H00000X
CA129834106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist