Provider Demographics
NPI:1609276682
Name:MCCLINTON, BRIAN D (LPC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:MCCLINTON
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 1:14618 WINDJAMMER DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4373
Mailing Address - Country:US
Mailing Address - Phone:804-350-7952
Mailing Address - Fax:
Practice Address - Street 1:1909 HUGUENOT RD STE 301
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4314
Practice Address - Country:US
Practice Address - Phone:804-350-7952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional