Provider Demographics
NPI:1184141707
Name:MCLEAN, DANNIELLE M (LCPC, LADC)
Entity type:Individual
Prefix:MS
First Name:DANNIELLE
Middle Name:M
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-3296
Mailing Address - Country:US
Mailing Address - Phone:207-324-1137
Mailing Address - Fax:207-324-5290
Practice Address - Street 1:707 SABLE OAKS DR STE 230
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6954
Practice Address - Country:US
Practice Address - Phone:207-774-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6870101YA0400X
MECAC6275101YA0400X
MECC5545101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty