Provider Demographics
NPI:1376067017
Name:MCCLAIN, CHRISTINA MARGARET (MA, LAPC, NCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARGARET
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MA, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 VILLAGE PKWY NE STE 580
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 VILLAGE PKWY NE STE 580
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4161
Practice Address - Country:US
Practice Address - Phone:770-726-9589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional