Provider Demographics
NPI:1215150248
Name:MCCLURE, SHARON S (LPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MANTOOTH AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3014
Mailing Address - Country:US
Mailing Address - Phone:936-639-4993
Mailing Address - Fax:936-639-6838
Practice Address - Street 1:501 MANTOOTH AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3014
Practice Address - Country:US
Practice Address - Phone:936-639-4993
Practice Address - Fax:936-639-6838
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59867101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
85310LOtherBLUE CROSS/BLUE SHIELD