Provider Demographics
NPI:1376055228
Name:MCCLAIN, MELISSA LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LOUISE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 WILLOW GLEN RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-5454
Mailing Address - Country:US
Mailing Address - Phone:318-487-4400
Mailing Address - Fax:318-487-0525
Practice Address - Street 1:1217 WILLOW GLEN RIVER RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-5458
Practice Address - Country:US
Practice Address - Phone:318-487-4400
Practice Address - Fax:318-487-0525
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA81821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical