Provider Demographics
NPI:1942414941
Name:MCKAY, CATHERINE D (MA LLP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:D
Last Name:MCKAY
Suffix:
Gender:F
Credentials:MA LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:ELK RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49629-9732
Mailing Address - Country:US
Mailing Address - Phone:231-590-0332
Mailing Address - Fax:
Practice Address - Street 1:1000 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3445
Practice Address - Country:US
Practice Address - Phone:231-947-8110
Practice Address - Fax:231-947-3522
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005190103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)