Provider Demographics
NPI:1427172808
Name:MCCREERY, MAUREEN (MED, PSYD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:MCCREERY
Suffix:
Gender:F
Credentials:MED, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 LINDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2702
Mailing Address - Country:US
Mailing Address - Phone:314-533-2229
Mailing Address - Fax:314-533-7496
Practice Address - Street 1:4330 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2702
Practice Address - Country:US
Practice Address - Phone:314-533-2229
Practice Address - Fax:314-533-7496
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006038987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical