Provider Demographics
NPI:1922898220
Name:MCLEAN, MOLLY BEA (LPC0012071)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BEA
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LPC0012071
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:BELLVUE
Mailing Address - State:CO
Mailing Address - Zip Code:80512-0311
Mailing Address - Country:US
Mailing Address - Phone:303-819-4046
Mailing Address - Fax:
Practice Address - Street 1:786 OLD CAMP ROAD
Practice Address - Street 2:
Practice Address - City:BELLVUE
Practice Address - State:CO
Practice Address - Zip Code:80512
Practice Address - Country:US
Practice Address - Phone:303-819-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional