Provider Demographics
NPI:1649729633
Name:MCKAY, WILLIAM L (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:MCKAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 GERALD PL
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-4831
Mailing Address - Country:US
Mailing Address - Phone:307-399-3126
Mailing Address - Fax:
Practice Address - Street 1:703 GERALD PL
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-4831
Practice Address - Country:US
Practice Address - Phone:307-399-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional