Provider Demographics
NPI:1417423112
Name:MCLEAN, AMANDA KAE NORE (MSW, CMHS)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KAE NORE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MSW, CMHS
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:KAE
Other - Last Name:NORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:3900 S ZINTEL WAY FL 2
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-5092
Practice Address - Country:US
Practice Address - Phone:509-942-3125
Practice Address - Fax:509-585-8173
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALW60940913104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health