Provider Demographics
NPI:1922203132
Name:MCCLAIN, HEATHER ANN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MASON ST
Mailing Address - Street 2:UNIT 6
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2260
Mailing Address - Country:US
Mailing Address - Phone:978-744-1585
Mailing Address - Fax:978-825-5617
Practice Address - Street 1:41 MASON ST
Practice Address - Street 2:UNIT 6
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2260
Practice Address - Country:US
Practice Address - Phone:978-744-1585
Practice Address - Fax:978-825-5617
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1159621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical