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General NPI Number Information
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NPI Number | 1831682038
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Entity Type | Organization
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Legal Business Name | MCLAIN COUNSELING LLC
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 1089 BUFORD HWY
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City | SUGAR HILL
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State | GA
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Zip | 30518-4820
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Country | US
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Telephone | 678-906-9782
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Fax |
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Provider Business Mailing Address
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Address Line | 224 REGAL DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4771
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Country | US
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Telephone | 678-906-9782
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOHN M MCLAIN
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Credential | LMFT
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Telephone | 678-906-9782
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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 | MFT001391
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License Number State | GA
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