Provider Demographics
NPI:1881230860
Name:SMCCLURE LCSW LLC
Entity Type:Organization
Organization Name:SMCCLURE LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:FEIG
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-655-9983
Mailing Address - Street 1:25 E WASHINGTON ST STE 1406
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1820
Mailing Address - Country:US
Mailing Address - Phone:773-655-9983
Mailing Address - Fax:
Practice Address - Street 1:25 E WASHINGTON ST STE 1406
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1820
Practice Address - Country:US
Practice Address - Phone:773-655-9983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health