Provider Demographics
NPI:1205683562
Name:JANE MCLIN, LCPC, LLC
Entity type:Organization
Organization Name:JANE MCLIN, LCPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:779-361-0713
Mailing Address - Street 1:1974 FLAGSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4993
Mailing Address - Country:US
Mailing Address - Phone:815-953-3744
Mailing Address - Fax:815-936-6199
Practice Address - Street 1:1180 N CONVENT ST
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1004
Practice Address - Country:US
Practice Address - Phone:779-361-0713
Practice Address - Fax:815-936-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty