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General NPI Number Information
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NPI Number | 1790267334
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Entity Type | Individual
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Provider Name | BRANDON LEE MCCLANAHAN MSSW, CSW
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Gender | Male
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 618 E MARKET ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-2914
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Country | US
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Telephone | 812-280-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 618 E MARKET ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-2914
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33009076A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 253446
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License Number State | KY
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