Provider Demographics
NPI:1437269719
Name:MCCLURE, STELLA LOUISE (MSW)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:LOUISE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1278
Mailing Address - Country:US
Mailing Address - Phone:614-257-5213
Mailing Address - Fax:614-257-5205
Practice Address - Street 1:543 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1278
Practice Address - Country:US
Practice Address - Phone:614-257-5213
Practice Address - Fax:614-257-5205
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010834261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical