Provider Demographics
NPI:1932343837
Name:MCCLELLAN, CARRI ANN (MA, LPC-MHSP-S, LMHC)
Entity type:Individual
Prefix:
First Name:CARRI
Middle Name:ANN
Last Name:MCCLELLAN
Suffix:
Gender:F
Credentials:MA, LPC-MHSP-S, LMHC
Other - Prefix:
Other - First Name:CARRI
Other - Middle Name:ANN
Other - Last Name:MCCRARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10904 KINGSTON PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2952
Mailing Address - Country:US
Mailing Address - Phone:865-568-5489
Mailing Address - Fax:
Practice Address - Street 1:201 W SPRINGDALE AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-5158
Practice Address - Country:US
Practice Address - Phone:865-637-9711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TN6664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor