Provider Demographics
NPI:1831255470
Name:MCCLASKEY, CONNIE ROLLAND II (LMFT)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:ROLLAND
Last Name:MCCLASKEY
Suffix:II
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 S COURT ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-5426
Mailing Address - Country:US
Mailing Address - Phone:559-627-3775
Mailing Address - Fax:559-627-8444
Practice Address - Street 1:1910 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5426
Practice Address - Country:US
Practice Address - Phone:559-627-3775
Practice Address - Fax:559-627-8444
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist