Provider Demographics
NPI:1497789432
Name:MC CLEARY, PAULA M (LPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:MC CLEARY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 CONCHO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6735
Mailing Address - Country:US
Mailing Address - Phone:713-201-5752
Mailing Address - Fax:713-774-4662
Practice Address - Street 1:2600 SOUTH LOOP W
Practice Address - Street 2:SUITE 475-K
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2653
Practice Address - Country:US
Practice Address - Phone:713-201-5752
Practice Address - Fax:713-774-4662
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4168LCOtherBCBS