Provider Demographics
NPI:1043855646
Name:MCCLELLAND, MAUREEN L (LCPC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:L
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 S HOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-6303
Mailing Address - Country:US
Mailing Address - Phone:773-505-2668
Mailing Address - Fax:
Practice Address - Street 1:10735 S CICERO AVE STE 208
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6214
Practice Address - Country:US
Practice Address - Phone:708-424-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional