MEDICARE: MS. KRISTINA ELIZABETH MCCRAY M.S. LPC, LSSP

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
2	101Y00000X	Counselor	75888	TX
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	75888	TX
4	101YP2500X	Professional Counselor	75888	TX

General Provider Information

NPI Number	:	1649812868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTINA ELIZABETH MCCRAY M.S. LPC, LSSP

Provider Business Mailing Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

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

Provider Enumeration Date	:	10/09/2019
Last Update Date	:	09/25/2025

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