Healthcare Provider Details

I. General information

NPI: 1639099229
Provider Name (Legal Business Name): MCCLAIN KELLY WARREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SCHENCK PKWY BLDG 2B
ASHEVILLE NC
28803-5053
US

IV. Provider business mailing address

94 DANDELION DR
CLYDE NC
28721-8664
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 786-379-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: