Provider Demographics
NPI:1316650302
Name:MCBRIDE, JOSEPH CLAIRE ELAYNE (LCSWA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CLAIRE ELAYNE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 LYNNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-9166
Mailing Address - Country:US
Mailing Address - Phone:210-420-8816
Mailing Address - Fax:
Practice Address - Street 1:115 KILDAIRE PARK DR STE 313
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8144
Practice Address - Country:US
Practice Address - Phone:919-600-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP018461104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker