Provider Demographics
NPI:1073001780
Name:MCCLURE, RACHEL (LPCC-S)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2227
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44054-0227
Mailing Address - Country:US
Mailing Address - Phone:440-223-7156
Mailing Address - Fax:216-435-7363
Practice Address - Street 1:223 MILLER RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1004
Practice Address - Country:US
Practice Address - Phone:330-331-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500293101YP2500X
OHE.1800701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282184Medicaid