Provider Demographics
NPI:1235991357
Name:MCLAIN, TERESA BROOKE (LPC-A)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:BROOKE
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16705 GRESHAM CIR
Mailing Address - Street 2:ST. 202
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762
Mailing Address - Country:US
Mailing Address - Phone:903-931-1906
Mailing Address - Fax:
Practice Address - Street 1:16705 GRESHAM CIR
Practice Address - Street 2:ST. 202
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-7576
Practice Address - Country:US
Practice Address - Phone:903-931-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health