Provider Demographics
NPI:1477866770
Name:MCCLURE, ANGELA SUE (LMHC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:SUE
Other - Last Name:HOHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:336 E BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8155
Mailing Address - Country:US
Mailing Address - Phone:813-943-6874
Mailing Address - Fax:
Practice Address - Street 1:336 E BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8155
Practice Address - Country:US
Practice Address - Phone:813-943-6874
Practice Address - Fax:813-689-0435
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health