Provider Demographics
NPI:1245352467
Name:MCCLELLAN, CHEZ J (LSCSW)
Entity type:Individual
Prefix:MS
First Name:CHEZ
Middle Name:J
Last Name:MCCLELLAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 SW 30TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2232
Mailing Address - Country:US
Mailing Address - Phone:785-274-3100
Mailing Address - Fax:785-274-3822
Practice Address - Street 1:200 SW 30TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2232
Practice Address - Country:US
Practice Address - Phone:785-274-3100
Practice Address - Fax:785-274-3822
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical