Provider Demographics
NPI:1285962555
Name:MCLEAN, SHARON RENEE (MSW, CMT, LCPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:RENEE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MSW, CMT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 MOUNTAIN VIEW DR S
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-6623
Mailing Address - Country:US
Mailing Address - Phone:406-544-4243
Mailing Address - Fax:406-273-0288
Practice Address - Street 1:5522 MOUNTAIN VIEW DR S
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6623
Practice Address - Country:US
Practice Address - Phone:406-544-4243
Practice Address - Fax:406-273-0288
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1465101YP2500X
MT785225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist