Provider Demographics
NPI:1598821472
Name:MCCAIN, VICKI LYNN (BA SOCIAL WORK)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:LYNN
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:BA SOCIAL WORK
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:LYNN
Other - Last Name:ALBERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA SOCIAL WORK
Mailing Address - Street 1:533 E WILCOXON
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646
Mailing Address - Country:US
Mailing Address - Phone:870-853-9989
Mailing Address - Fax:
Practice Address - Street 1:1308 W 5TH ST
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635
Practice Address - Country:US
Practice Address - Phone:870-364-6471
Practice Address - Fax:870-364-9753
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker