Provider Demographics
NPI:1679887038
Name:MCKEE, TARA E (PHD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:E
Last Name:MCKEE
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 1:198 COLLEGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-1218
Mailing Address - Country:US
Mailing Address - Phone:315-859-4216
Mailing Address - Fax:
Practice Address - Street 1:7325 STATE ROUTE 5
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-3435
Practice Address - Country:US
Practice Address - Phone:315-859-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016239-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical