Provider Demographics
NPI:1841782133
Name:MCCLELLAND, MAUREEN MARY (LPC, RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MARY
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 GROGANS MILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1144
Mailing Address - Country:US
Mailing Address - Phone:936-777-1457
Mailing Address - Fax:832-442-3453
Practice Address - Street 1:10210 GROGANS MILL RD STE 300
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1144
Practice Address - Country:US
Practice Address - Phone:214-226-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional