Provider Demographics
NPI:1033834072
Name:MCCLOAT, KEVIN M (CASAC-T)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:M
Last Name:MCCLOAT
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 ROUTE 376 STE 201
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6493
Mailing Address - Country:US
Mailing Address - Phone:845-765-2366
Mailing Address - Fax:845-765-2367
Practice Address - Street 1:942 ROUTE 376 STE 201
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6493
Practice Address - Country:US
Practice Address - Phone:845-765-2366
Practice Address - Fax:845-765-2367
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37076101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)