Provider Demographics
NPI:1558478669
Name:VANCLEAVE, MARGIE (LPC)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:VANCLEAVE
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 1:506 GLASCOW ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1406
Mailing Address - Country:US
Mailing Address - Phone:361-576-3385
Mailing Address - Fax:361-573-7425
Practice Address - Street 1:506 GLASCOW ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1406
Practice Address - Country:US
Practice Address - Phone:613-576-3385
Practice Address - Fax:613-573-7425
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional