Provider Demographics
NPI:1225714348
Name:MCLAIN, BRYAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 PARK VISTA CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5693
Mailing Address - Country:US
Mailing Address - Phone:817-812-2880
Mailing Address - Fax:817-812-3096
Practice Address - Street 1:12520 WILLOW SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3584
Practice Address - Country:US
Practice Address - Phone:817-812-2880
Practice Address - Fax:817-812-3096
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health