Provider Demographics
NPI:1417298969
Name:HITE, MARCY KAY (AUD, PHD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:KAY
Last Name:HITE
Suffix:
Gender:F
Credentials:AUD, PHD, CCC-A
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:KAY
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684-0699
Mailing Address - Country:US
Mailing Address - Phone:423-439-4584
Mailing Address - Fax:423-439-4607
Practice Address - Street 1:156 SOUTH DOSSETT DRIVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37614-1702
Practice Address - Country:US
Practice Address - Phone:423-439-4355
Practice Address - Fax:423-439-4607
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80449231H00000X
TNSP1853231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD14062359OtherASHA BOARD CERTIFICATE
TX80449OtherTEXAS LICENSURE
TNQ034178Medicaid
TNSP1853OtherSTATE OF TENNESSEE DEPARTMENT OF HEALTH DIVISION OF HEALTH LICENSURE AND REGULAT