Provider Demographics
NPI:1740540137
Name:MCKAY, MICHELLE (LMFT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MCKAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BROWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1604 S SANTA FE AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-5062
Mailing Address - Country:US
Mailing Address - Phone:951-654-2026
Mailing Address - Fax:951-654-9927
Practice Address - Street 1:27412 ENTERPRISE CIR W STE 200&205
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4803
Practice Address - Country:US
Practice Address - Phone:951-971-6262
Practice Address - Fax:951-462-4018
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA111290106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist