Provider Demographics
NPI:1972606762
Name:MCCLEAN, JENNIFER L (LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:MCCLEAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:MCCLEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JENNIFER MCCLEAN
Mailing Address - Street 1:6354 PAINTER AVE STE D
Mailing Address - Street 2:SUITE D
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4632
Mailing Address - Country:US
Mailing Address - Phone:562-693-6766
Mailing Address - Fax:562-698-7058
Practice Address - Street 1:6354 PAINTER AVE STE D
Practice Address - Street 2:SUITE D
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4632
Practice Address - Country:US
Practice Address - Phone:562-693-6766
Practice Address - Fax:562-698-7058
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical