Provider Demographics
NPI:1467060467
Name:MCCLELLAND, ROY JR (LPC)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:MCCLELLAND
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5569 PALM SPRINGS DR APT C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6692
Mailing Address - Country:US
Mailing Address - Phone:614-301-5708
Mailing Address - Fax:
Practice Address - Street 1:90 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1659
Practice Address - Country:US
Practice Address - Phone:614-783-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002448-TRNE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor