Provider Demographics
NPI:1851979256
Name:MCCLEOD, DARNELL E (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DARNELL
Middle Name:E
Last Name:MCCLEOD
Suffix:
Gender:M
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:PO BOX 1992
Mailing Address - Street 2:
Mailing Address - City:MESILLA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88047-1992
Mailing Address - Country:US
Mailing Address - Phone:575-805-6288
Mailing Address - Fax:
Practice Address - Street 1:1685 S DON ROSER DR STE D
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4586
Practice Address - Country:US
Practice Address - Phone:575-805-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX118581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical