Healthcare Provider Details
I. General information
NPI: 1851781926
Provider Name (Legal Business Name): RENACHANTEL MCCLAIN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/28/2015
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13854 LAKESIDE CIR
STERLING HEIGHTS MI
48313-1443
US
IV. Provider business mailing address
PO BOX 1171
STERLING HEIGHTS MI
48311-1171
US
V. Phone/Fax
- Phone: 248-284-3203
- Fax: 248-715-6505
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 4101006637 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: