Provider Demographics
NPI:1003132580
Name:MCLEAN, KATIE EILEEN (MSED, LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:EILEEN
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MSED, LMHC
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:EILEEN
Other - Last Name:MCLEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1182 TROY SCHENECTADY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1000
Mailing Address - Country:US
Mailing Address - Phone:518-400-5180
Mailing Address - Fax:518-940-4420
Practice Address - Street 1:1182 TROY SCHENECTADY RD STE 204
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1000
Practice Address - Country:US
Practice Address - Phone:518-400-5180
Practice Address - Fax:518-940-4420
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health