Provider Demographics
NPI:1093167587
Name:MCCLURE, LINDA (LPC; MAC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LPC; MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 TALKING LEAVES TRL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-4666
Mailing Address - Country:US
Mailing Address - Phone:706-206-4619
Mailing Address - Fax:
Practice Address - Street 1:505 GREEN STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501
Practice Address - Country:US
Practice Address - Phone:706-206-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional