Provider Demographics
NPI:1679855209
Name:MCCLYMONDS, JAMES (PSYD, HSPP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MCCLYMONDS
Suffix:
Gender:M
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E MONROE ST STE 3800
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-6030
Mailing Address - Country:US
Mailing Address - Phone:312-348-6296
Mailing Address - Fax:312-881-7501
Practice Address - Street 1:55 E MONROE ST STE 3800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6030
Practice Address - Country:US
Practice Address - Phone:312-348-6296
Practice Address - Fax:312-881-7501
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IN20042930A103T00000X
IL071.009367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical