Healthcare Provider Details

I. General information

NPI: 1558277186
Provider Name (Legal Business Name): VICKIE P MCCREARY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3911 WINTERCRESS CT
COLUMBUS OH
43207-4631
US

IV. Provider business mailing address

3911 WINTERCRESS CT
COLUMBUS OH
43207-4631
US

V. Phone/Fax

Practice location:
  • Phone: 614-353-6502
  • Fax: 614-442-8824
Mailing address:
  • Phone: 614-353-6502
  • Fax: 614-442-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3009
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: