Provider Demographics
NPI:1306978895
Name:MCCAULAY, MARCI (PHD)
Entity type:Individual
Prefix:DR
First Name:MARCI
Middle Name:
Last Name:MCCAULAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0186
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 N PROSPECT ST
Practice Address - Street 2:SUITE 9
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1371
Practice Address - Country:US
Practice Address - Phone:740-587-1375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3459103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical