MEDICARE: KASSANDRA AITANA MCCLAIN LPC, NCC

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	101YM0800X	Mental Health Counselor	92840	TX

General Provider Information

NPI Number	:	1467231555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASSANDRA AITANA MCCLAIN LPC, NCC

Provider Business Mailing Address
First Line	:	9318 DURHAM TRCE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-5543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9318 DURHAM TRCE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-5543
Country	:	US
Telephone Number	:	210-609-4755
Fax Number	:

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

Provider Enumeration Date	:	09/27/2023
Last Update Date	:	04/08/2026

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