MEDICARE: MRS. MAUREEN ANN MCKAY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6401010555	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	750910402	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1053691931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAUREEN ANN MCKAY LPC

Provider Business Mailing Address
First Line	:	456 REAUME CT
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2485
Country	:	US
Telephone Number	:	586-788-9554
Fax Number	:	586-948-9304

Provider Business Practice Location Address
First Line	:	42815 GARFIELD RD STE 201
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1143
Country	:	US
Telephone Number	:	586-333-5328
Fax Number	:	586-948-9304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	02/19/2026

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