Provider Demographics
NPI:1609643030
Name:MCCLANAHAN, SUSAN KIMBERLY (M ED, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KIMBERLY
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:M ED, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4013
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508
Mailing Address - Country:US
Mailing Address - Phone:304-855-1222
Mailing Address - Fax:304-310-2307
Practice Address - Street 1:93 MCCLANAHAN LN
Practice Address - Street 2:
Practice Address - City:DELBARTON
Practice Address - State:WV
Practice Address - Zip Code:25670-1506
Practice Address - Country:US
Practice Address - Phone:304-784-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV274369101YM0800X
KY274369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health