Provider Demographics
NPI:1609945468
Name:MCLAREN, KEVIN PATRICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PATRICK
Last Name:MCLAREN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 GREENHILL LN
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2924
Mailing Address - Country:US
Mailing Address - Phone:434-386-0777
Mailing Address - Fax:
Practice Address - Street 1:2740 GREENHILL LN
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2924
Practice Address - Country:US
Practice Address - Phone:434-386-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810-2452103TC0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4946219Medicaid
VA7707151Medicaid