1992892566 NPI number — JOHN MCLAIN LCSW

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992892566 NPI number — JOHN MCLAIN LCSW

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MCLAIN

Provider First Name:

JOHN

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

LCSW

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1992892566

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3100 EUBANKS RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

DURHAM

Provider Business Mailing Address State Name:

NC

Provider Business Mailing Address Postal Code:

27707-3623

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

919-270-6525

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

100 CAPITOLA DR STE 108

Provider Second Line Business Practice Location Address:

ALEXANDRIA TECHNOLOGY CENTER

Provider Business Practice Location Address City Name:

DURHAM

Provider Business Practice Location Address State Name:

NC

Provider Business Practice Location Address Postal Code:

27713-4496

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

919-484-0601

Provider Business Practice Location Address Fax Number:

919-484-0306

Provider Enumeration Date:

10/06/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 1041C0700X , with the licence number:  C000338 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 6002356 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
• Identifier: 60260 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 2110776 . This is a "MAMSI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 6002385 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
• Identifier: C000338 . This is a "UBH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 2119613 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: C000338 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 131411 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 258078 . This is a "MHN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 60260 . This is a "HEALTHCHOICE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 60260 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 6272698 . This is a "UBH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".