Provider Demographics
NPI:1700392313
Name:MCCLURE, CAROL (LPCC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3023
Mailing Address - Country:US
Mailing Address - Phone:614-314-7833
Mailing Address - Fax:
Practice Address - Street 1:615 COPELAND MILL RD STE 2C
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8904
Practice Address - Country:US
Practice Address - Phone:614-381-7912
Practice Address - Fax:614-476-0338
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE.1700395OtherOHIO LICENSE BOARD