Provider Demographics
NPI:1477154359
Name:MCCREARY, TAYLOR (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MCCREARY
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 1:3308 RUBY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-4358
Mailing Address - Country:US
Mailing Address - Phone:440-453-7132
Mailing Address - Fax:
Practice Address - Street 1:106 STARRET ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3993
Practice Address - Country:US
Practice Address - Phone:740-687-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional