Provider Demographics
NPI:1871601179
Name:MCCLURE, THOMAS GORDON (LCSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GORDON
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 GAFF LN
Mailing Address - Street 2:
Mailing Address - City:PEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:71964-9461
Mailing Address - Country:US
Mailing Address - Phone:501-767-7825
Mailing Address - Fax:
Practice Address - Street 1:1401 MALVERN AVE
Practice Address - Street 2:SUITE 152
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6327
Practice Address - Country:US
Practice Address - Phone:501-624-0700
Practice Address - Fax:501-624-2705
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR420-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical