Provider Demographics
NPI:1205540564
Name:MCKAY, ISABELLE VIVIAN (LPC)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:VIVIAN
Last Name:MCKAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18009 N 40TH PL APT 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-1762
Mailing Address - Country:US
Mailing Address - Phone:952-807-3499
Mailing Address - Fax:
Practice Address - Street 1:18009 N 40TH PL APT 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1762
Practice Address - Country:US
Practice Address - Phone:952-807-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health