Provider Demographics
NPI:1982730842
Name:MCCLURE, SUSAN YOUNG (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:YOUNG
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5561 MCNEELY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7625
Mailing Address - Country:US
Mailing Address - Phone:919-786-0603
Mailing Address - Fax:919-786-6019
Practice Address - Street 1:5561 MCNEELY DR STE 301
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7625
Practice Address - Country:US
Practice Address - Phone:919-786-0603
Practice Address - Fax:919-786-6019
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC907103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist