Provider Demographics
NPI:1821747361
Name:MCCAY, ELISE (LMFTA)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:MCCAY
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-3021
Mailing Address - Country:US
Mailing Address - Phone:832-623-9652
Mailing Address - Fax:
Practice Address - Street 1:3305 81ST ST STE H
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2028
Practice Address - Country:US
Practice Address - Phone:832-623-9652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203346106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0OtherPRIVATE PAY