Provider Demographics
NPI:1487415774
Name:MCCRARY, HALEY (LMSW)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12406 N 32ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7146
Mailing Address - Country:US
Mailing Address - Phone:623-499-3218
Mailing Address - Fax:
Practice Address - Street 1:2201 CORONADA WAY S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-4133
Practice Address - Country:US
Practice Address - Phone:701-429-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW187621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical