Provider Demographics
NPI:1699316398
Name:MCCRAY, BABETTE (CDCA)
Entity type:Individual
Prefix:
First Name:BABETTE
Middle Name:
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:BABETTE
Other - Middle Name:
Other - Last Name:MCCRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PACE
Mailing Address - Street 1:909 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 SYCAMORE ST STE 400
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1306
Practice Address - Country:US
Practice Address - Phone:513-651-9300
Practice Address - Fax:513-556-4354
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.170596101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCDCA.170596OtherCDCA