Provider Demographics
NPI:1518208057
Name:MCCLEARY, JAMEEL MICHAEL
Entity Type:Individual
Prefix:
First Name:JAMEEL
Middle Name:MICHAEL
Last Name:MCCLEARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 E RUSSELL RD UNIT 2021
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-8012
Mailing Address - Country:US
Mailing Address - Phone:267-325-9406
Mailing Address - Fax:
Practice Address - Street 1:717 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-7014
Practice Address - Country:US
Practice Address - Phone:702-386-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst