Provider Demographics
NPI:1306288477
Name:MCCLURE, RACHEL MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 HAMPTON LN NW
Mailing Address - Street 2:APT 2A
Mailing Address - City:WALKER
Mailing Address - State:MI
Mailing Address - Zip Code:49534-7808
Mailing Address - Country:US
Mailing Address - Phone:231-590-3297
Mailing Address - Fax:
Practice Address - Street 1:528 HAMPTON LN NW
Practice Address - Street 2:APT 2A
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534-7808
Practice Address - Country:US
Practice Address - Phone:231-590-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010953971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical