Provider Demographics
NPI:1558401117
Name:MCLAIN, LIBBY M (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:LIBBY
Middle Name:M
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 SW 6TH ST
Mailing Address - Street 2:SUITE 18
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2910
Mailing Address - Country:US
Mailing Address - Phone:541-472-8100
Mailing Address - Fax:
Practice Address - Street 1:980 SW 6TH ST
Practice Address - Street 2:SUITE 18
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2910
Practice Address - Country:US
Practice Address - Phone:541-472-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health