Provider Demographics
NPI:1467545665
Name:MCCLELLAN, DANIEL R (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:R
Last Name:MCCLELLAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5721
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-0721
Mailing Address - Country:US
Mailing Address - Phone:918-810-8237
Mailing Address - Fax:
Practice Address - Street 1:1202 MCCLAIN RD SUITE 141
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3875
Practice Address - Country:US
Practice Address - Phone:918-810-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK967106H00000X
MO2012012968106H00000X
ARM1010008106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist