Provider Demographics
NPI:1760141634
Name:MCCLOUD, KERI E (LPC)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:E
Last Name:MCCLOUD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:E
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1012 NW CANDLETREE DR
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-2760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7280 NW 87TH TER STE C-210
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-3720
Practice Address - Country:US
Practice Address - Phone:643-453-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021046278101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty