Individual provider Active NPI

Trevor McKay

  • Professional Counselor
  • Columbia, MD
National Provider Identifier
1417504788
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
8970 Route 108 Ste B
Columbia, MD 21045-2145
Phone
(443) 330-7900
NPI assigned
Aug 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

8970 Route 108 Ste B
Columbia, MD 21045-2145

Mailing address

8970 Route 108 Ste B
Columbia, MD 21045-2145
Phone (443) 330-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930001814 DC Practitioner - Mental Health Counselor 0143751305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 23, 2024 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1417504788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8970 ROUTE 108 STE B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452145",
            "telephone_number": "443-330-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8970 ROUTE 108 STE B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452145",
            "telephone_number": "443-330-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.