Active NPI
Stafford McKay, BA
- Addiction (Substance Use Disorder) Counselor
- Traverse City, MI
National Provider Identifier
1649426982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 06302011
- Practice address
- 1105 6TH St
Traverse City, MI 49684-2345 - Phone
- (231) 256-7676
- NPI assigned
- Aug 18, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 06302011 | MI | Primary |
Addresses
Primary practice location
1105 6TH St
Traverse City, MI 49684-2345
Mailing address
1105 6TH Street
Traverse City, MI 49684
Phone (231) 256-7676
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)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06302011 | MI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219017600000",
"number": "1649426982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 6TH STREET",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-256-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 6TH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345",
"telephone_number": "231-256-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKAY",
"first_name": "STAFFORD",
"name_prefix": "Mr.",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-18",
"last_updated": "2008-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "06302011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.