Provider Demographics
NPI:1700297843
Name:MCLIN, JANE M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:M
Last Name:MCLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.004442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional