Provider Demographics
NPI:1750345609
Name:MACLEAY, JAN (LPC)
Entity type:Individual
Prefix:MS
First Name:JAN
Middle Name:
Last Name:MACLEAY
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 1:754 MIRIAM LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29472-7030
Mailing Address - Country:US
Mailing Address - Phone:843-412-5277
Mailing Address - Fax:
Practice Address - Street 1:754 MIRIAM LN
Practice Address - Street 2:
Practice Address - City:RIDGEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29472-7030
Practice Address - Country:US
Practice Address - Phone:843-412-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-15
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4698101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor