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General NPI Number Information
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NPI Number | 1932878113
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Entity Type | Individual
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Provider Name | CHRISTOPHER MCCLURE
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Gender | Male
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 344 ROLLING HILL RD STE 203C
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City | MOORESVILLE
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State | NC
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Zip | 28117-6865
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Country | US
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Telephone | 980-231-1582
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Fax |
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Provider Business Mailing Address
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Address Line | 382 ROBINSON RD
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City | MOORESVILLE
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State | NC
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Zip | 28117-9035
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Country | US
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Telephone | 937-344-5213
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-27429
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License Number State | NC
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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 |
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License Number State |
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