Provider Demographics
NPI:1184459992
Name:MCLEAN, CARRIE FREDERICK (PHD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:FREDERICK
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MARTHA LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-9639
Mailing Address - Country:US
Mailing Address - Phone:910-631-1036
Mailing Address - Fax:910-483-1720
Practice Address - Street 1:205 MARTHA LN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-9639
Practice Address - Country:US
Practice Address - Phone:910-631-1036
Practice Address - Fax:910-483-1720
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-29815101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)