Provider Demographics
NPI:1366122913
Name:MCCLARY, ROBERT D (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:MCCLARY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CHAMPIONS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061-9807
Mailing Address - Country:US
Mailing Address - Phone:916-479-1593
Mailing Address - Fax:
Practice Address - Street 1:124 CHAMPIONS RIDGE CT
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:SC
Practice Address - Zip Code:29061-9807
Practice Address - Country:US
Practice Address - Phone:916-479-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health