Provider Demographics
NPI:1871262220
Name:MCCLURE, NANCY CLARK (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:CLARK
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LPC
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 363
Mailing Address - Street 2:
Mailing Address - City:LOST CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26385-0363
Mailing Address - Country:US
Mailing Address - Phone:304-626-5256
Mailing Address - Fax:
Practice Address - Street 1:613 W PIKE ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2626
Practice Address - Country:US
Practice Address - Phone:304-622-5323
Practice Address - Fax:304-622-5324
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional