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General NPI Number Information
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NPI Number | 1124417167
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Entity Type | Organization
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Legal Business Name | MCLEAN WELLNESS GROUP, INC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 119 WICKHAM RD
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City | GLASTONBURY
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State | CT
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Zip | 06033-2549
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Country | US
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Telephone | 860-578-4808
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Fax | 866-355-1052
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Provider Business Mailing Address
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Address Line | PO BOX 1011
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City | BRISTOL
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State | CT
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Zip | 06011-1011
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Country | US
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Telephone | 860-578-4808
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Fax | 866-355-1052
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | APRIL A. MCLEAN
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Credential |
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Telephone | 860-578-4808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 000899
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 899
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8731
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002946
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License Number State | CT
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