Provider Demographics
NPI:1902903974
Name:MACLACHLAN, MARY F (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:MACLACHLAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:F
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1898 CALHOUN ST
Mailing Address - Street 2:#5 RAINBOW ROW
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2612
Mailing Address - Country:US
Mailing Address - Phone:803-233-9239
Mailing Address - Fax:803-233-9118
Practice Address - Street 1:1898 CALHOUN ST
Practice Address - Street 2:#5 RAINBOW ROW
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2612
Practice Address - Country:US
Practice Address - Phone:803-233-9239
Practice Address - Fax:803-233-9118
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC291103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPS0077Medicaid