MEDICARE: MARTA ANN MCKAY LPC / CAC III

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	101YM0800X	Mental Health Counselor	0000911	CO

General Provider Information

NPI Number	:	1730288713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTA ANN MCKAY LPC / CAC III

Provider Business Mailing Address
First Line	:	3370 ASH HOPPER LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-6214
Country	:	US
Telephone Number	:	719-331-5462
Fax Number	:

Provider Business Practice Location Address
First Line	:	5350 TOMAH DR.,
Second Line	:	ST. 3500
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6976
Country	:	US
Telephone Number	:	719-574-6562
Fax Number	:	719-475-7171

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	06/04/2025

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