Provider Demographics
NPI:1821479601
Name:MCCLORY, MICHELLE N (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:N
Last Name:MCCLORY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 W GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-2200
Mailing Address - Country:US
Mailing Address - Phone:313-554-0485
Mailing Address - Fax:
Practice Address - Street 1:27776 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0930
Practice Address - Country:US
Practice Address - Phone:248-556-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007986A1041C0700X
MI68010976761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical