Healthcare Provider Details

I. General information

NPI: 1245029701
Provider Name (Legal Business Name): JIBRI ASWAD MCLEAN M.S., LPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N RADNOR CHESTER RD STE F200
RADNOR PA
19087-5245
US

IV. Provider business mailing address

150 N RADNOR CHESTER RD STE F200
RADNOR PA
19087-5245
US

V. Phone/Fax

Practice location:
  • Phone: 267-587-6722
  • Fax:
Mailing address:
  • Phone: 267-587-6722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC020518
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: