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General NPI Number Information
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NPI Number | 1265735815
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Entity Type | Individual
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Provider Name | MARTHA ELIZABETH MCCLURE MA, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 186 IRON KETTLE RD
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City | WARNER
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State | NH
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Zip | 03278-4403
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Country | US
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Telephone | 303-502-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 186 IRON KETTLE RD
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City | WARNER
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State | NH
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Zip | 03278-4403
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Country | US
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Telephone | 303-502-4775
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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 | 5283
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License Number State | CO
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