Provider Demographics
NPI:1588066062
Name:MCCAA-WILBORN, NATALIE (LPC-S)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:MCCAA-WILBORN
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 OAK KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4512
Mailing Address - Country:US
Mailing Address - Phone:682-706-1056
Mailing Address - Fax:
Practice Address - Street 1:4400 OAK KNOLL CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4512
Practice Address - Country:US
Practice Address - Phone:682-706-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional