Provider Demographics
NPI:1497415756
Name:MCCRAY, CLARENCE II (MS)
Entity Type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:
Last Name:MCCRAY
Suffix:II
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 POWHATAN ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-6512
Mailing Address - Country:US
Mailing Address - Phone:434-219-9785
Mailing Address - Fax:434-219-6394
Practice Address - Street 1:3500 POWHATAN ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-6512
Practice Address - Country:US
Practice Address - Phone:434-219-9785
Practice Address - Fax:434-219-6394
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)