Provider Demographics
NPI:1962734640
Name:MCCRAY, ZAVIER NICHOLS (LCSW)
Entity type:Individual
Prefix:MS
First Name:ZAVIER
Middle Name:NICHOLS
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 COURT ST
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2503
Mailing Address - Country:US
Mailing Address - Phone:919-340-1626
Mailing Address - Fax:
Practice Address - Street 1:211 COURT ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2503
Practice Address - Country:US
Practice Address - Phone:919-340-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005216251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC104100000XMedicaid