Provider Demographics
NPI:1568860484
Name:CHRISTIENNE MORSE MCCLURE PLLC
Entity Type:Organization
Organization Name:CHRISTIENNE MORSE MCCLURE PLLC
Other - Org Name:LIFE TRANSITIONS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIENNE
Authorized Official - Middle Name:MORSE
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-895-2522
Mailing Address - Street 1:PO BOX 851
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20168-0851
Mailing Address - Country:US
Mailing Address - Phone:703-895-2522
Mailing Address - Fax:888-509-0859
Practice Address - Street 1:9254 B MOSBY STREET
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-895-5208
Practice Address - Fax:888-509-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA701004917101YP2500X
IDLMFTI-3076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003125667OtherNPI