Provider Demographics
NPI:1063799278
Name:MCCLELLAND, ASHLEY (MA, LMFTA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 MOODY AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2515B NASA PKWY
Practice Address - Street 2:SUITE 10
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-3448
Practice Address - Country:US
Practice Address - Phone:832-356-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201739106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist