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General NPI Number Information
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NPI Number | 1497921894
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Entity Type | Individual
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Provider Name | AUTUMN MCLELLAN MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 3858 WALKER BLVD STE 1
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City | ERIE
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State | PA
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Zip | 16509-1627
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Country | US
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Telephone | 814-882-0046
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Fax |
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Provider Business Mailing Address
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Address Line | 9098 W LAKE RD
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City | LAKE CITY
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State | PA
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Zip | 16423-2102
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Country | US
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Telephone | 814-882-0046
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Fax | 814-528-5010
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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 | PC004866
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License Number State | PA
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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 | PC004866
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License Number State | PA
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