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General NPI Number Information
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NPI Number | 1003900291
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Entity Type | Individual
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Provider Name | KIMBERLY T MCCLARY LPC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 106 SPRINGVIEW LN
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8108
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Country | US
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Telephone | 843-821-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 CHARLIE HALL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29414-5832
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Country | US
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Telephone | 843-852-4100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8341
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License Number State | SC
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