Provider Demographics
NPI:1437508843
Name:JAMES ADAM MCCRACKEN, PH.D., LLC
Entity Type:Organization
Organization Name:JAMES ADAM MCCRACKEN, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:MCCRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-695-3664
Mailing Address - Street 1:1806 TOWN PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6206
Mailing Address - Country:US
Mailing Address - Phone:407-695-3664
Mailing Address - Fax:407-695-3674
Practice Address - Street 1:1806 TOWN PLAZA CT
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6206
Practice Address - Country:US
Practice Address - Phone:407-695-3664
Practice Address - Fax:407-695-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7525103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty