Provider Demographics
NPI:1609920560
Name:MCLEAN, EDWARD ALEXANDER (MA, LLP, LPC, CACI)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ALEXANDER
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:MA, LLP, LPC, CACI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 SOUTH KALAMAZOO MALL
Mailing Address - Street 2:SUITE 250
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007
Mailing Address - Country:US
Mailing Address - Phone:269-383-1440
Mailing Address - Fax:269-383-9781
Practice Address - Street 1:157 SOUTH KALAMAZOO MALL
Practice Address - Street 2:SUITE 250
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007
Practice Address - Country:US
Practice Address - Phone:269-383-1440
Practice Address - Fax:269-383-9781
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI100321101YA0400X
MI6401005779101YM0800X
MI6301007668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health