Provider Demographics
NPI:1114360146
Name:MCLEMORE, DAVID (ICADC, CSAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:MCLEMORE
Suffix:
Gender:M
Credentials:ICADC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5211
Mailing Address - Country:US
Mailing Address - Phone:828-264-2727
Mailing Address - Fax:
Practice Address - Street 1:128 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5211
Practice Address - Country:US
Practice Address - Phone:828-264-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2302101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)