Provider Demographics
NPI:1588704134
Name:MCLEAN, PEARLINE BROWN (LPC)
Entity type:Individual
Prefix:
First Name:PEARLINE
Middle Name:BROWN
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ISABELLE ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-2838
Mailing Address - Country:US
Mailing Address - Phone:910-276-8111
Mailing Address - Fax:
Practice Address - Street 1:508 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4027
Practice Address - Country:US
Practice Address - Phone:910-276-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4621101YP2500X
SC3457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102711Medicaid