Provider Information for 1457501272
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STEPHEN MCCRARY LCSW
Sex: Male
NPI: 1457501272
Last Updated: 2024-10-14
Certification Date: 2024-10-14
Certification Date: 2024-10-14
Details
| Name | Value | ||||||||||||||||
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| NPI | 1457501272 | ||||||||||||||||
| Enumeration Date | 2008-09-29 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 7150 PLANTATION RD APT 112 PENSACOLA, FL 32504-6201 United States Phone: 503-881-7346 | Fax: | ||||||||||||||||
| Primary Practice Address | 7150 PLANTATION RD APT 112 PENSACOLA, FL 32504-6201 United States Phone: 503-881-7346 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 3180 CENTER ST NE # 3360 1221 W LAKEVIEW AVE | ||||||||||||||||
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