Provider Demographics
NPI:1538485339
Name:MCCUE, BRIAN (LPC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MCCUE
Suffix:
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 1:1723 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9715
Mailing Address - Country:US
Mailing Address - Phone:484-860-6016
Mailing Address - Fax:215-257-9347
Practice Address - Street 1:1723 N 18TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9715
Practice Address - Country:US
Practice Address - Phone:484-860-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103664320-0003Medicaid