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General NPI Number Information
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NPI Number | 1477612232
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Entity Type | Individual
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Provider Name | EVERETT GERARD MCLAREN ED.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 312 GRANITE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-2144
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Country | US
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Telephone | 804-288-6734
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Fax | 804-288-8923
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Provider Business Mailing Address
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Address Line | 1217 THE FRST
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City | CROZIER
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State | VA
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Zip | 23039-2421
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Country | US
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Telephone | 804-784-2641
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Fax | 804-288-8923
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701000639
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License Number State | VA
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