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General NPI Number Information
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NPI Number | 1467545665
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Entity Type | Individual
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Provider Name | DANIEL R. MCCLELLAN LMFT
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 1202 MCCLAIN RD SUITE 141
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City | BENTONVILLE
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State | AR
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Zip | 72712-3875
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Country | US
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Telephone | 918-810-8237
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5721
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City | BELLA VISTA
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State | AR
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Zip | 72714-0721
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Country | US
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Telephone | 918-810-8237
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 967
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2012012968
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M1010008
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License Number State | AR
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