Provider Demographics
NPI:1134846710
Name:MCCLAIN, LYLE ANN (LMFT)
Entity type:Individual
Prefix:
First Name:LYLE
Middle Name:ANN
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 NEWCASTLE ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1338
Mailing Address - Country:US
Mailing Address - Phone:310-903-1386
Mailing Address - Fax:
Practice Address - Street 1:3625 E THOUSAND OAKS BLVD STE 131
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3555
Practice Address - Country:US
Practice Address - Phone:310-903-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132874106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist