Provider Demographics
NPI:1922523919
Name:MCCLAIN, GREGOIRE (MA LCPC CAS)
Entity Type:Individual
Prefix:MR
First Name:GREGOIRE
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:MA LCPC CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PATHWASY INC 2670 CRAIN HWY
Mailing Address - Street 2:SUITE 409
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601
Mailing Address - Country:US
Mailing Address - Phone:301-373-3065
Mailing Address - Fax:240-309-4131
Practice Address - Street 1:PATHWAYS INC 2670 CRAIN HWY
Practice Address - Street 2:SUITE 409
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601
Practice Address - Country:US
Practice Address - Phone:301-373-3065
Practice Address - Fax:240-309-4131
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCAS2698101YA0400X
MDLC1935101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health