Provider Demographics
NPI:1962027276
Name:MCCRAY, ALEXIS T (MA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:T
Last Name:MCCRAY
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 1:14620 ACHIM DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7374
Mailing Address - Country:US
Mailing Address - Phone:240-527-9821
Mailing Address - Fax:
Practice Address - Street 1:14620 ACHIM DR
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7374
Practice Address - Country:US
Practice Address - Phone:240-527-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional