Provider Demographics
NPI:1275775793
Name:MCCLINCEY, BRIAN D (MA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:MCCLINCEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W BAKERVIEW ROAD
Mailing Address - Street 2:SUITE 110, OFFICE 148
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7941
Mailing Address - Country:US
Mailing Address - Phone:360-255-8260
Mailing Address - Fax:
Practice Address - Street 1:410 W BAKERVIEW ROAD
Practice Address - Street 2:SUITE 110, OFFICE 148
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9822
Practice Address - Country:US
Practice Address - Phone:360-255-8260
Practice Address - Fax:360-734-5298
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007634101YP2500X
WALH60678050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional