MEDICARE: MRS. PATRICIA ANNA MCLEAN MS, LMFT, LPC

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	101YP2500X	Professional Counselor	2003018541	MO
2	106H00000X	Marriage & Family Therapist	2005007365	MO

General Provider Information

NPI Number	:	1356120323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA ANNA MCLEAN MS, LMFT, LPC

Provider Business Mailing Address
First Line	:	600 W REPUBLIC RD STE A116
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-5805
Country	:	US
Telephone Number	:	417-324-5257
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W REPUBLIC RD STE A116
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-5805
Country	:	US
Telephone Number	:	417-324-5257
Fax Number	:

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

Provider Enumeration Date	:	09/27/2023
Last Update Date	:	09/27/2023

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