MEDICARE: DR. DIANE A. MCKAY PSY.D.

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	103TC2200X	Clinical Child & Adolescent Psychologist	6237	FL
2	103TH0100X	Health Service Psychologist	6237	FL
3	103TC0700X	Clinical Psychologist	6237	FL
4	103TB0200X	Cognitive & Behavioral Psychologist	6237	FL
5	103TA0400X	Addiction (Substance Use Disorder) Psychologist	6237	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54681	OTHER	FL	BCBS PROVIDER #

General Provider Information

NPI Number	:	1013989433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE A. MCKAY PSY.D.

Provider Business Mailing Address
First Line	:	8051 N TAMIAMI TRL STE F10
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-2097
Country	:	US
Telephone Number	:	941-243-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	8051 N TAMIAMI TRL STE F10
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-2097
Country	:	US
Telephone Number	:	941-243-0300
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	01/14/2026

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