Provider Demographics
NPI:1427656602
Name:MCNAIR, JOE (PHD, MFT)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:MCNAIR
Suffix:
Gender:M
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 OAKDALE AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2673
Mailing Address - Country:US
Mailing Address - Phone:818-317-4940
Mailing Address - Fax:
Practice Address - Street 1:5525 OAKDALE AVE STE 410
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2673
Practice Address - Country:US
Practice Address - Phone:818-317-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist