Provider Demographics
NPI:1336706944
Name:MCCLEARN, KATHRYN (LPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MCCLEARN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 N BLACK CANYON HWY STE 103OFC10
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4109
Mailing Address - Country:US
Mailing Address - Phone:602-845-0707
Mailing Address - Fax:
Practice Address - Street 1:8601 N BLACK CANYON HWY STE 103OFC10
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4109
Practice Address - Country:US
Practice Address - Phone:602-845-0707
Practice Address - Fax:602-296-0398
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional