MEDICARE: LAURA M MCCLINTON LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MF000905	PA

General Provider Information

NPI Number	:	1205847605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA M MCCLINTON LMFT

Provider Business Mailing Address
First Line	:	390 COMMERCE DR # 235
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2600
Country	:	US
Telephone Number	:	215-259-8444
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 COMMERCE DR # 235
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2600
Country	:	US
Telephone Number	:	215-259-8444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/06/2025

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