Provider Demographics
NPI:1013648336
Name:MCLAMB, ANA MARIA (MA, ATR, LMHC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:MCLAMB
Suffix:
Gender:F
Credentials:MA, ATR, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 TIMBER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IN
Mailing Address - Zip Code:47460-5989
Mailing Address - Country:US
Mailing Address - Phone:812-821-3337
Mailing Address - Fax:
Practice Address - Street 1:3100 E JOHN HINKLE PL
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-2630
Practice Address - Country:US
Practice Address - Phone:812-323-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001535A101YM0800X
IL180.014835101YP2500X
21-468221700000X
IN39004409A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist