Healthcare Provider Details

I. General information

NPI: 1033768437
Provider Name (Legal Business Name): AMBER MCKAY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 78TH AVE N STE 101
BROOKLYN PARK MN
55445-2719
US

IV. Provider business mailing address

6900 78TH AVE N STE 101
BROOKLYN PARK MN
55445-2719
US

V. Phone/Fax

Practice location:
  • Phone: 763-432-6875
  • Fax: 763-432-6894
Mailing address:
  • Phone: 763-432-6875
  • Fax: 763-432-6894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: