Healthcare Provider Details

I. General information

NPI: 1376325514
Provider Name (Legal Business Name): VERONICA JANE MCLAREN PSY D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RONNIE JANE MCLAREN LPC

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MACDONOUGH PL
MIDDLETOWN CT
06457-3607
US

IV. Provider business mailing address

468 MAIN ST APT 9
MIDDLETOWN CT
06457-2851
US

V. Phone/Fax

Practice location:
  • Phone: 860-358-8825
  • Fax:
Mailing address:
  • Phone: 281-455-8794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4961
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: