Healthcare Provider Details

I. General information

NPI: 1811490915
Provider Name (Legal Business Name): KIMBERLY C MCCRAY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8198 S JOG RD STE 200
BOYNTON BEACH FL
33472-2998
US

IV. Provider business mailing address

1421 W 32ND ST
RIVIERA BEACH FL
33404-3563
US

V. Phone/Fax

Practice location:
  • Phone: 561-810-6631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC017119
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: