Provider Demographics
NPI:1093309080
Name:MCCLAIN, LORI (LSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 THAYER RD
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-8595
Mailing Address - Country:US
Mailing Address - Phone:585-738-0283
Mailing Address - Fax:
Practice Address - Street 1:19 THAYER RD
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-8595
Practice Address - Country:US
Practice Address - Phone:585-738-0283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132712104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker