Provider Demographics
NPI:1487964664
Name:MCAULIFFE, WAYNE E (MFT)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:E
Last Name:MCAULIFFE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 WATT ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-2838
Mailing Address - Country:US
Mailing Address - Phone:775-741-3671
Mailing Address - Fax:
Practice Address - Street 1:9492 DOUBLE R BLVD STE B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4820
Practice Address - Country:US
Practice Address - Phone:775-741-3671
Practice Address - Fax:775-322-8316
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist