Provider Demographics
NPI:1588970453
Name:MCCLELLAND, ERIN LEE (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LEE
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEE
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2534 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-3250
Mailing Address - Country:US
Mailing Address - Phone:702-336-3214
Mailing Address - Fax:
Practice Address - Street 1:1975 MCPHERSON ST
Practice Address - Street 2:SUITE #2
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-3482
Practice Address - Country:US
Practice Address - Phone:541-751-2556
Practice Address - Fax:541-751-2661
Is Sole Proprietor?:No
Enumeration Date:2010-08-29
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL71601041C0700X
NV6104-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical