MEDICARE: LAURA MAY MCINNIS LPC

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	101YP2500X	Professional Counselor	7263	TN
2	101YP2500X	Professional Counselor	80521	TX

General Provider Information

NPI Number	:	1780275883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MAY MCINNIS LPC

Provider Business Mailing Address
First Line	:	1907 N ROAN ST STE 202
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-3182
Country	:	US
Telephone Number	:	423-737-7762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1907 N ROAN ST STE 202
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37601-3182
Country	:	US
Telephone Number	:	423-737-7762
Fax Number	:

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

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	02/23/2026

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