Provider Demographics
NPI:1528166899
Name:MCCLELLAN, JO ANNE (LMHC)
Entity type:Individual
Prefix:MS
First Name:JO ANNE
Middle Name:
Last Name:MCCLELLAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N MORAIN ST
Mailing Address - Street 2:212
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2905
Mailing Address - Country:US
Mailing Address - Phone:509-737-9660
Mailing Address - Fax:509-737-9610
Practice Address - Street 1:100 N MORAIN ST
Practice Address - Street 2:212
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2905
Practice Address - Country:US
Practice Address - Phone:509-737-9660
Practice Address - Fax:509-737-9610
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health