Provider Demographics
NPI:1518658996
Name:MCCLAIN-EL, TREVON
Entity Type:Individual
Prefix:
First Name:TREVON
Middle Name:
Last Name:MCCLAIN-EL
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 1:4332 TELFAIR BLVD
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4263
Mailing Address - Country:US
Mailing Address - Phone:301-664-3103
Mailing Address - Fax:
Practice Address - Street 1:915 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1733
Practice Address - Country:US
Practice Address - Phone:301-664-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator