Provider Demographics
NPI:1598814675
Name:MCCLURE MANN, HEATHER ERIN (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ERIN
Last Name:MCCLURE MANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:MCCLURE
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5858 W MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4194
Mailing Address - Country:US
Mailing Address - Phone:972-981-4213
Mailing Address - Fax:972-981-4219
Practice Address - Street 1:5858 W MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4194
Practice Address - Country:US
Practice Address - Phone:972-981-4213
Practice Address - Fax:972-981-4219
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30295OtherLCSW