Provider Demographics
NPI:1548533144
Name:MCCLAIN, THOMAS LOUIS II (LPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LOUIS
Last Name:MCCLAIN
Suffix:II
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 1:189 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-6037
Mailing Address - Country:US
Mailing Address - Phone:704-968-7163
Mailing Address - Fax:
Practice Address - Street 1:1478 AUTUMN WOOD TRL
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8629
Practice Address - Country:US
Practice Address - Phone:704-968-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009184101YP2500X
MA333-MH-CC-TEMP101YP2500X
VA0701010051101YP2500X
TX84402101YP2500X
GALPC008974101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional