MEDICARE: DR. BRUCE EDWARD MCCLURE PHD, LCPC,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	46790	MD
2	101YP2500X	Professional Counselor	LC0718	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11613455	OTHER	MD	CAQH ID

General Provider Information

NPI Number	:	1649375825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE EDWARD MCCLURE PHD, LCPC,NCC

Provider Business Mailing Address
First Line	:	7800 CENTRAL AVE
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4807
Country	:	US
Telephone Number	:	301-333-5150
Fax Number	:	301-333-5161

Provider Business Practice Location Address
First Line	:	7800 CENTRAL AVE
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-4807
Country	:	US
Telephone Number	:	301-333-5150
Fax Number	:	301-333-5161

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/11/2025

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