MEDICARE: KEVIN J. MCCREARY M.ED., 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	68963	TX

General Provider Information

NPI Number	:	1790815702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN J. MCCREARY M.ED., LPC

Provider Business Mailing Address
First Line	:	1302 TEASLEY LN
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-7946
Country	:	US
Telephone Number	:	940-343-7941
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 TEASLEY LN
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-7946
Country	:	US
Telephone Number	:	940-343-7941
Fax Number	:

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/27/2015

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