Provider Demographics
NPI:1194519934
Name:MCCRAY, DANELLE LANETTE
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:LANETTE
Last Name:MCCRAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 LARUE LN
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:GA
Mailing Address - Zip Code:30421-6638
Mailing Address - Country:US
Mailing Address - Phone:912-314-0967
Mailing Address - Fax:
Practice Address - Street 1:229 LARUE LN
Practice Address - Street 2:
Practice Address - City:COLLINS
Practice Address - State:GA
Practice Address - Zip Code:30421-6638
Practice Address - Country:US
Practice Address - Phone:912-314-0712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)