Provider Demographics
NPI:1750436077
Name:CARRIE MCCLUER & ASSOCIATES
Entity type:Organization
Organization Name:CARRIE MCCLUER & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLUER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-787-6960
Mailing Address - Street 1:PO BOX 23993
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-0993
Mailing Address - Country:US
Mailing Address - Phone:510-787-6960
Mailing Address - Fax:510-787-6960
Practice Address - Street 1:628 2ND AVE STE 204
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:CA
Practice Address - Zip Code:94525-1175
Practice Address - Country:US
Practice Address - Phone:510-787-6960
Practice Address - Fax:510-787-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28082261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)