Provider Demographics
NPI:1790085330
Name:MCCRAY, VALERIE (PHD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-0107
Mailing Address - Country:US
Mailing Address - Phone:317-253-7387
Mailing Address - Fax:317-253-7388
Practice Address - Street 1:3016 LAKE SHORE DR
Practice Address - Street 2:UNIT E
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2324
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:317-253-7388
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042020A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical