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NPI Code Detail

MEDICARE: DEREK H MCCLURE MA, LPC

MEDICARE:   DEREK H MCCLURE  MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2012008595MO

General Provider Information

NPI Number : 1023401205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK H MCCLURE MA, LPC
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5214
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 90 E LESLIE LN
Second Line :
City : COLUMBIA
State : MO
Zip : 65202-1589
Country : US
Telephone Number : 573-875-8880
Fax Number : 573-442-3830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2015
Last Update Date : 04/09/2025

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Directions to “ DEREK H MCCLURE MA, LPC” Practice Location

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