Provider Demographics
NPI:1871369173
Name:MCCRARY, MARY MICHELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:MICHELLE
Last Name:MCCRARY
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 1:3837 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-7703
Mailing Address - Country:US
Mailing Address - Phone:504-233-4720
Mailing Address - Fax:
Practice Address - Street 1:3837 LOYOLA DR
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-7703
Practice Address - Country:US
Practice Address - Phone:504-579-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health