Individual provider Active NPI

Marvaughn Maxine McCray

  • Addiction (Substance Use Disorder) Counselor
  • Port St Lucie, FL
National Provider Identifier
1902684277
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
751 SE Voltair Ter
Port St Lucie, FL 34983-3868
Phone
(561) 294-2760
NPI assigned
Sep 18, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

751 SE Voltair Ter
Port St Lucie, FL 34983-3868

Mailing address

751 SE Voltair Ter
Port St Lucie, FL 34983-3868
Phone (561) 294-2760

Other practice location 1

751 SE Voltair Ter
Port St Lucie, FL 34983-3868
Phone (561) 294-2760

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

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1902684277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 SE VOLTAIR TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833868",
            "telephone_number": "561-294-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 SE VOLTAIR TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349833868",
            "telephone_number": "561-294-2760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 SE Voltair Ter",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349833868",
            "country_code": "US",
            "telephone_number": "561-294-2760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRAY",
        "first_name": "MARVAUGHN",
        "middle_name": "MAXINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.