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General NPI Number Information
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NPI Number | 1275936320
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Entity Type | Individual
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Provider Name | TENISHA NICOLE MCLEAN LCMHCS
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Gender | Female
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 810 CANNONADE DR
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City | WHITSETT
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State | NC
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Zip | 27377-8010
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Country | US
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Telephone | 336-312-9982
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Fax |
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Provider Business Mailing Address
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Address Line | 810 CANNONADE DR
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City | WHITSETT
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State | NC
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Zip | 27377-8010
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Country | US
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Telephone | 336-312-9982
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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 | S11052
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License Number State | NC
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