Provider Demographics
NPI:1427656024
Name:MCLAIN, ELISABETH (CADC)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291943
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1943
Mailing Address - Country:US
Mailing Address - Phone:615-488-0702
Mailing Address - Fax:615-488-0708
Practice Address - Street 1:41 ACME RD STE 2
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1543
Practice Address - Country:US
Practice Address - Phone:833-356-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6217101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)