Active NPI
Theresa Lynn McKay, LMSW
- Clinical Social Worker
- Port Huron, MI
National Provider Identifier
1063422939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801069777
- Practice address
- 3111 Electric Ave
Port Huron, MI 48060-8127 - Phone
- (810) 966-3576
- Fax
- (810) 985-7620
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801069777 | MI | Primary |
Addresses
Primary practice location
3111 Electric Ave
Port Huron, MI 48060-8127
Mailing address
3771 Conifer Court
Burtchville, MI 48059
Phone (810) 385-3749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1063422939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3771 CONIFER COURT",
"city": "BURTCHVILLE",
"state": "MI",
"postal_code": "48059",
"telephone_number": "810-385-3749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 ELECTRIC AVE",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480608127",
"telephone_number": "810-966-3576",
"fax_number": "810-985-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKAY",
"first_name": "THERESA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801069777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.