Provider Demographics
NPI:1043881998
Name:MCCLURE, HAVEN MACGREGOR (APSW)
Entity Type:Individual
Prefix:MR
First Name:HAVEN
Middle Name:MACGREGOR
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:APSW
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:ALLAN
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1517 E HUEBBE PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-1795
Mailing Address - Country:US
Mailing Address - Phone:815-276-4432
Mailing Address - Fax:608-713-9040
Practice Address - Street 1:1517 E HUEBBE PKWY STE A
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1795
Practice Address - Country:US
Practice Address - Phone:815-276-4432
Practice Address - Fax:608-713-9040
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health