Provider Demographics
NPI:1972776276
Name:MCLELLAN, STEPHEN DUDLEY (MA, MBA)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:DUDLEY
Last Name:MCLELLAN
Suffix:
Gender:M
Credentials:MA, MBA
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Mailing Address - Street 1:205 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-2781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2781
Practice Address - Country:US
Practice Address - Phone:978-632-2321
Practice Address - Fax:978-630-3049
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health