Provider Demographics
NPI:1457556532
Name:BRENNAN MCKAYE, PH.D., P.A.
Entity Type:Organization
Organization Name:BRENNAN MCKAYE, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MCKAYE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-365-7777
Mailing Address - Street 1:6150 GRAYGATE LN APT F
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-4062
Mailing Address - Country:US
Mailing Address - Phone:704-365-7777
Mailing Address - Fax:704-553-2513
Practice Address - Street 1:6809 FAIRVIEW RD
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3336
Practice Address - Country:US
Practice Address - Phone:704-365-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2891103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty