Provider Demographics
NPI:1730288713
Name:MCKAY, MARTA ANN (LPC / CAC III)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:ANN
Last Name:MCKAY
Suffix:
Gender:F
Credentials:LPC / CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 ASH HOPPER LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-6214
Mailing Address - Country:US
Mailing Address - Phone:719-579-0263
Mailing Address - Fax:
Practice Address - Street 1:1115 ELKTON DR
Practice Address - Street 2:ST. 403
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8507
Practice Address - Country:US
Practice Address - Phone:719-538-3311
Practice Address - Fax:719-570-0386
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health