Provider Demographics
NPI:1447350731
Name:MCLEAN, JEFFERY TROY (LCSW)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:TROY
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:TROY
Other - Middle Name:
Other - Last Name:MCLEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3723 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-2917
Mailing Address - Country:US
Mailing Address - Phone:919-672-9522
Mailing Address - Fax:919-865-8821
Practice Address - Street 1:3801 LAKE BOONE TRL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2934
Practice Address - Country:US
Practice Address - Phone:919-672-9522
Practice Address - Fax:919-865-8821
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical