Provider Demographics
NPI:1679893473
Name:MCKAY, TRACY ANN (MA)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:ANN
Last Name:MCKAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-3089
Mailing Address - Country:US
Mailing Address - Phone:423-771-9138
Mailing Address - Fax:423-376-1233
Practice Address - Street 1:3085 BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-3089
Practice Address - Country:US
Practice Address - Phone:423-771-9138
Practice Address - Fax:423-376-1233
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2818101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional